Level 30

175 Liverpool Street

SYDNEY NSW 2000

GPO Box 15

SYDNEY NSW 2001

DX17 SYDNEY

T: 02 8776 3575

www.nswlrs.com.au

E-Transaction Production Receipt

Note: This form is used exclusively for non-encumbered Certificate of Titles issued prior to 1 /1/2004 for the purpose of electronic lodgment.

Certificate of Title Reference

Edition Date where applicable

Edition Number where applicable

PRODUCED BY

Producing Party Name

Address

Phone No. (Mandatory)

Email

CLIENT’S REFERENCE

PURPOSE FOR WHICH THIS TITLE IS PRODUCED

Dealing Type to be lodged

Name of Parties Receiving e.g. Mortgagee, Transferee, Lessee etc.

FOR NSW LRS USE ONLY

PRODUCTION RECEIPT ID

NSW LRS OFFICER

DATE RECEIVED

NOTE: PRODUCED CERTIFICATES OF TITLE WILL BE RETAINED FOR THREE MONTHS