Form LRA 17 (r.

28(4), 29(4))
REPUBLIC OF KENYA

THE LAND REGISTRATION ACT

THE LAND REGISTRATION (GENERAL) REGULATIONS, 2017

DEED OF INDEMNITY

THIS DEED OF INDEMNITY is made on the ....................................... day of ..............................

two thousand and Twenty-Three by the [.], whose address is care of Post Office Box Number [.], Nairobi in the said
Republic (hereinafter called “the Owner”).

W H E R E A S:-
1. The Owner is registered as proprietor of ALL THAT piece of land situate in the [.] of Nairobi County measuring
approximately three (3) acres, known as land reference number [.] being the land comprised in a Deed of Conveyance
dated [.]made between the owner on the one part and [.] (hereinafter called “the Property”).

2. The Advocates for the Owner have applied for a search over the Property and have been informed by the Officers
(hereinafter defined) that the Deed file relating to the Property cannot be traced at the Land Titles Registry and that
to carry out a search, the said Deed File is required to be reconstructed for which purpose the Owner has been
requested to issue this Deed of Indemnity.

3. The Owner has not caused and is in no way involved with the disappearance of the original Deed file

4. The Owner is desirous of reconstructing the Deed File.

5. This Deed of Indemnity is supplemental to the Affidavit annexed hereto sworn by the Owner.

NOW THIS DEED WITNESSETH that the Owner shall indemnify and hold harmless the Government of the
Republic of Kenya its officers and agents (“the Officers”) from and against all actions proceedings claims demands
costs expenses and losses whatsoever arising from the reconstruction of the Deed file (“the Losses”) PROVIDED
THAT the Losses arise out of a fraud or illegality on the part of the Owner and PROVIDED FURTHER THAT the
indemnity contained herein shall determine on the date on which the Owner ceases to be the registered proprietor of the
Property.

IN WITNESS WHEREOF the Owner has hereunto caused its Common Seal to be hereunto affixed the day and year
first hereinbefore written.

SEALED with the Common Seal of the Owner in the presence of:

Authorized Representative
 REPUBLIC OF KENYA
IN THE MATTER OF OATHS & STATUTORY DECLARATIONS ACT
CAP 15 LAWS OF KENYA

AND

IN THE MATTER OF LAND REFERENCE NUMBER 214/14

(AFFIDAVIT IN SUPPORT OF AN APPLICATION TO RECONSTRUCT LAND REGISTER)

I, [.] of Post Office Box Number [.], Nairobi in the Republic of Kenya and passport number [.], do make oath and state as
follows:-

1. THAT I am an adult of sound mind and disposition, the [.] in Nairobi, duly authorised and well versed with the
matter herein hence competent to swear this declaration.

2. THAT the [.] is the registered proprietor of all that property known as Land Reference Number [.] (the land)
pursuant to a Deed of Conveyance [.] herewith and marked as ‘SJA 1’ is a copy of the Deed of Conveyance.

3. THAT sometime in the year 2022, the Embassy attempted to undertake a registry search of the title and was
informed the land register is not available and as such it was not possible to undertake the registry search.
Attached herewith and marked as ‘SJA 2’ is a letter from the lands registry confirming the land register is not
available.

4. THAT the [.] should proceed and make the application for reconstruction of the register directly hence the present
application.

5. THAT following futile attempts to locate the land register with respect to the land, the [.] has no alternative save
for making the present application.

6. THAT the [.] is now desirous of applying for reconstruction of the land register with respect to the land.

7. THAT I swear this declaration to confirm that the land register with respect to the land is lost beyond recovery,
and in support of the application to reconstruct the land register.

8. THAT Save wherein otherwise expressly stated I make this declaration from facts within my knowledge,
information and belief and in accordance with the Oaths and Statutory Declarations Act Cap 15 Laws of Kenya.

I make this declaration conscientiously believing the same to be true and according to the Oaths and
Statutory Declaration Act.

DECLARED before me at Nairobi

on the ……………day of………….……20…

……………….………………….
[.]
In the presence of

Signature of Commissioner for Oaths or

Magistrate or Notary Public

*The Applicant should be the registered Proprietor or the person entitled thereto under the Law.