Land Titles Initiative - Apply | Nova Scotia Legal Aid

NOVA SCOTIA LEGAL AID LAND TITLES APPLICATION

Personal information you provide on this form is collected on behalf of Province of Nova Scotia Land Title Initiative under the authority of the Nova Scotia Freedom of Information and Protection of Privacy (FOIPOP) Act. We collect, use and retain your personal information for the purpose investigating and processing your Land titles application. We will only disclose your personal information when necessary to administer the program or when otherwise required by law or if we obtain your consent.

LAST NAME: *

FIRST & MIDDLE NAME: *

DATE OF BIRTH: *

MM/DD/YY

GENDER IDENTIFICATION: *

MALE

FEMALE

OTHER

SELF-IDENTIFICATION

I self-identify as African-Nova Scotian or Black

I self-identify as Indigenous (First Nation, Métis, Inuit)

Address *

Country

City

State

Zip code

Home Phone #:

Work Phone #:

Cell Phone #:

Email Address:

I authorize Nova Scotia Legal Aid to contact me regarding my matter via the following electronic means:

Text Message:

YES

Cell Phone Provider:

In order for NSLA to contact you via text we will need your cell phone provider. Example: Bell, Kudo, Telus, Rogers

Land Titles Clarification Issue:

For Property Located at:

Property Address:

City:

Postal Code:

READ DECLARATION AND AUTHORIZATION CAREFULLY:

Applicant declares that information provided is true and complete. Applicant will provide additional information as required. Applicant consents to have information investigated for verification. Applicant must notify Nova Scotia Legal Aid of any changes *

I Agree

Applicant authorizes Nova Scotia Legal Aid to represent and act for Applicant in the matter mentioned or any related matter and further authorizes Nova Scotia Legal Aid to take any necessary action or obtain required assistance. *

I Agree

SIGNATURE: *