For individual:
Attach (One) 1
passport Photo -graph
for r Customary C –ofO. Do not pin the face
please.
This Form is FREE and NOT FOR SALE
(This Form can be copied)
For Organizations:
Organization
stamp/seal
BENUE STATE OF NIGERIA, OTUKPO LOCAL GOVERNMENT AREA
OTUKPO INTEGRATED LAND SYSTEM (OTILS)G
APPLICATION FOR CUSTOMARY CERTIFICATE-OF-OCCUPANCY
Application Form for Private Individuals / Organization
FILE NO:
Private
Application Date:
Title:
First:
Gender:
Male:
Middle:
Female:
Nationality:
Marital Status:
Religion:
Education:
House No.
Surname:
Date of Birth:
Occupation:
Children:
State of Origin:
Single
Christianity
Primary
Married
Islam
Secondary
Street Name:
Local Gov.:
Separated
None
Tertiary
Divorced
Others specify
Others specify
Widowed
District:
City/Town
State:
Country:
P.O / PMB:
C/O
Additional Address information:
Organization
Name of Organization:
Type of Organization
NGO
Company/ Corporate
Registration Number (RC).
Date of Registration
Contact Person:
Title:
First:
Local Government Area:
Middle:
Designation:
Address of Organization / Company or Headquarter:
House No.
Street Name:
District:
TIN:
Institution (Health, Schools, Churches, Mosque)
Surname:
Phone:
City/Town
State:
Email:
Document of Demarcation submitted:
Survey Data / Coordinate:
Survey Report
Site Plan
TDP
Is the applicant the original land owner?
Yes
No
If “No” how did you acquire the plot and who is the owner?
Change of Ownership
Elders Consent
Power Of Attorney
Assignment
Allocation letter
Part Surrender
Sublease
Deed of Gift
Letter of Administration
Other:
Name of former owner:
Date of Transaction:
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L.G.A.:
Plot Size:
Plot Number:
Description of the Location of the Land
Purpose for which the land is used / required:
Value of Improvement:
Demarcation of Plot
Lease Term required:
the Plot is surveyed (survey Data submitted)
the Plot is NOT surveyed and I need a property identification
Write your comment:
Applicant Signature:
Contact Person / Representative Signature:
Document to submit for Application of Customary C-of-O (Organization)
Document to submit for Application of Customary C-of-O (Private)
Certified Bank Teller of Proof of Application fee payment
One passport sized Photograph
Copy of national ID Card or Inter. Passport or Driving License or Voters card
Certified Bank Teller of Proof of Application fee payment
Corporate Affairs Commission (CAC) Certificate of Incorporation /Registration
Site Plan or Survey Report or Coordinates or TDP
Change of Ownership and Clearance Form and Agreement (transfer or sale) or
Authorized Representative/ Contact person ID
Memorandum and Articles of Association
Site Plan or Survey Report or Coordinates or TDP
Change of Ownership and Clearance Form and Agreement (transfer or sale) or
Transaction Deed, or Letter of Administration, or power of Attorney
Old Customary Certificate of Occupancy (Where Applicable)
Elders Consent
Allocation letter
Police Report and Court Affidavit (Lost or Stolen Documents)
Two daily newspaper advertisements (one national) (Lost or Stolen Documents)
Transaction Deed or Letter of Admission or
Old Customary Certificate of Occupancy (Where Applicable)
Elders Consent
Allocation Letter
Police Report and Court Affidavit (Lost or Stolen Documents)

Please read and fill out this form very carefully.

For more Information get the full Application Guidelines from
O.T.I.L.S Customer Service or www.otils.ng
Two daily newspaper advertisements (one national and one state) (Lost or Stolen
Documents)
Guide to specify Landuse or Purpose Clause:
RESIDENTIAL
District Market
PUBLIC INSTITUTION
Small Shops / Corner Shops
Nursery School
INDUSTRIAL
Quarry
OPEN SPACE / GREEN AREA
Private Residential
Shopping Mall / Plaza
Day Care
Borrow Pit Mining/ minerals
Recreation and Holiday Resort
Neighborhood Centre
Shopping Complex
Nursery & Primary School
General Manufacturing
Game Reserve / Zoo
Primary School
Metal or Wood Factory
Sports Area
University
Paper, Chemicals, Textile
Golf Course
Secondary School
Stones, Sediment, Ceramics
Equestrian Centre
Educational Institution
Water Packaging, Bottling
Country Club / Health Farm
Research Institute
Agro-Allied
Neighborhood Park
Training / Vocation Cent. / College
Hospital
PUBLIC UTILITY UNIT
Staff Quarter / Life
ccccCampl
MIXED USE
Multi-Purpose
Special Development
Comprehensive Development
AGRICULTURAL
Farming
Office
Banking /Insurance /Services
Warehouse
Laboratory Bakery / Cafe'
Plant Nursery Workshop
Horticulture
Petrol Filling Station
COMMERCIAL
Commercial Housing Estate
Gas Refilling Station
Restaurant / Fast Food
Garage / Carwash
Internet Café Cinema / Theatre
Guest House (Hospitality)
Sports Facility
Motel
TRANSPORTATION
Bus Depot
Hostel
Hotel
Motor Park
Lorry / Trailer Park
Play Ground / Picnic Area
Recreational Centre
TV Or Radio station
Entertainment Complex
Power Station/ Subst./Transformer
Cemetery
Veterinary Clinic
Place of Worship
Post Office
National Memorial Park
Water Treatment Plant
Local Park
Mosque
Dump Site
District Park
Clinic
Dental Clinic
Prayer Site
Church
Library Community
Centre
Declaration: It is a punishable offence to provide any false information and / or make any false statements or claims when completing this form. Where it is subsequently discovered
that a Customary Certificate of Occupancy was issued based on false or inaccurate information, the Local Government may at its sole discretion, revoke such Customary C-of O.
OTILS reserves the right to reject any application form not properly or fully completed and shall not incur any liability for any such rejection. The information you supply on this form
is public knowledge may be published in the media. Completed forms, evidence of payment and documents to be returned to OTUKPO INTEGRATED LAND SYSTEM OFFICE at
Headquarters of Otukpo Local Government Council Office Otukpo Benue state..
Applicant Signature: ………………………………………............
Date:……………………………….
FOR OFFICIAL USE:
OTUKPO LGA LAND COMMITTEE (CONCURRENCE & APPROVAL)
Signature:……………………………….
Date:…………………………………….
.
OTILS Helpline: 090 684 281937or 080 987 656717
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