12The vendor's income tax return was lodged by—

12 The vendor's income tax return was lodged by— Occupation: The year of the last return being: †Schedule 2—Division 1—Particulars of mortgages, charges and prescribed encumbrances affecting the land Section 7(3) of the Act provides that this statement need not include reference to charges arising from the imposition of rates or taxes less than 12 months before the date of service of the statement. All the particulars required by column 3 of the table below in relation to a mortgage, charge or prescribed encumbrance referred to in column 1 must be set out in column 3 unless— (a) a copy of a document is attached to this statement and— (i) all the required particulars are contained in that document; and (ii) those parts of the document that contain the required particulars are identified in column 3; or (b) the mortgage, charge or prescribed encumbrance— (i) is 1 of the following items in the table: (A) under the heading "General"— • Mortgage of land • Lease, agreement for lease, tenancy agreement or licence; (B) under the heading "Other"— • Caveat • Lien or notice of a lien • Charge of any kind affecting the land (not included in another item); and (ii) is registered on the certificate of title to the land; and (iii) is to be discharged or satisfied prior to or at settlement.

Table of particulars Prescribed encumbrance Is the encumbrance to be discharged or satisfied prior to or at settlement? Column 3 Other particulars required Part 1—Items that must be included in statement [If an item is not applicable strike it out or write "NOT APPLICABLE" or "N/A" in column 1.] General Mortgage of land Number of mortgage (if registered): Name of mortgagee: Easement (whether over the land or annexed to the land) "Easement" includes rights of way and party wall rights. Description of land subject to easement: Nature of easement: Are you aware of any encroachment on the easement? *YES/NO (If YES, give details): If there is an encroachment, has approval for the encroachment been given? *YES/NO (If YES, give details): [attach additional page(s) if more than 1 easement] Restrictive covenant Nature of restrictive covenant: Name of person in whose favour restrictive covenant operates: Does the restrictive covenant affect the whole of the land being acquired? *YES/NO (If NO, give details): Does the restrictive covenant affect land other than that being acquired? *YES/NO Lease, agreement for lease, tenancy agreement or licence (The information does not include information about any sublease or subtenancy. That information may be sought by the purchaser from the lessee or tenant or sublessee or subtenant.) Period of lease, agreement for lease etc: From           to Amount of rent or licence fee: $          per          (period) Is the lease, agreement for lease etc in writing? *YES/NO If the lease or licence was granted under an Act relating to the disposal of Crown lands, specify— (a) the Act under which the lease or licence was granted: (b) the outstanding amounts due (including any interest or penalty): Development Act 1993 (repealed) section 42—Condition (that continues to apply) of a development authorisation Repealed Act conditions Condition (that continues to apply) of an approval or authorisation granted under the Building Act 1971 (repealed), the City of Adelaide Development Control Act 1976 (repealed), the Planning Act 1982 (repealed) or the Planning and Development Act 1967 (repealed) Nature of condition(s): Planning, Development and Infrastructure Act 2016 Part 5—Planning and Design Code Title or other brief description of zone, subzone and overlay in which the land is situated (as shown in the Planning and Design Code): Is there a State heritage place on the land or is the land situated in a State heritage area? *YES/NO Is the land designated as a local heritage place? *YES/NO Is there a tree or stand of trees declared in Part 10 of the Planning and Design Code to be a significant tree or trees on the land? *YES/NO Is there a current amendment to the Planning and Design Code released for public consultation by a designated entity on which consultation is continuing or on which consultation has ended but whose proposed amendment has not yet come into operation? *YES/NO For further information about the Planning and Design Code visit . section 127—Condition (that continues to apply) of a development authorisation Name of relevant authority that granted authorisation: Part 2—Items to be included if land affected [If an item is not applicable, strike it out or write "NOT APPLICABLE" or "N/A" in column 1, or else omit the items and headings that are not applicable.] Aboriginal Heritage Act 1988 section 9—Registration in central archives of an Aboriginal site or object Particulars of register entry: section 24—Directions prohibiting or restricting access to, or activities on, a site or an area surrounding a site Site or area to which notice relates: Directions (as stated in notice): Part 3 Division 6—Aboriginal heritage agreement Burial and Cremation Act 2013 section 8—Human remains interred on land Have human remains been interred on the land that will not be exhumed prior to settlement? *YES/NO GPS coordinates of the remains: Crown Rates and Taxes Recovery Act 1945 section 5—Notice requiring payment Land in respect of which Crown rates and taxes are owing: Amount owing (as stated in the notice): Development Act 1993 (repealed) section 50(1)—Requirement to vest land in a council or the Crown to be held as open space section 50(2)—Agreement to vest land in a council or the Crown to be held as open space section 55—Order to remove or perform work section 56—Notice to complete development section 57—Land management agreement section 60—Notice of intention by building owner section 69—Emergency order section 71—Fire safety notice section 84—Enforcement notice Name of relevant authority giving notice: section 85(6), 85(10) or 106—Enforcement order Part 11 Division 2—Proceedings Emergency Services Funding Act 1998 section 16—Notice to pay levy Environment Protection Act 1993 section 59—Environment performance agreement that is registered in relation to the land section 93—Environment protection order that is registered in relation to the land section 93A—Environment protection order relating to cessation of activity that is registered in relation to the land section 99—Clean‑up order that is registered in relation to the land section 100—Clean‑up authorisation that is registered in relation to the land Amount of charge on the land (if known): section 103H—Site contamination assessment order that is registered in relation to the land section 103J—Site remediation order that is registered in relation to the land section 103N—Notice of declaration of special management area in relation to the land (due to possible existence of site contamination) Description of area or areas to which the notice relates: section 103P—Notation of site contamination audit report in relation to the land Date of notation: Site contamination audit reports are kept by the EPA in the public register under section 109 of the Environment Protection Act 1993. section 103S—Notice of prohibition or restriction on taking water affected by site contamination in relation to the land Description of the water to which the notice relates: Particulars given in the notice of the site contamination affecting the water: Fences Act 1975 section 5—Notice of intention to perform fencing work Name and address of person to whom notice was given or from whom notice was received: Particulars of relevant boundary: Kind of fence proposed to be constructed or nature of work proposed to be done to existing fence: Cost or estimated cost of fence or work (as stated in the notice): Amount sought by proponent from adjoining owner (as stated in the notice): If there is a cross‑notice under section 6, give details of— (a) the proposals objected to: (b) the counter‑proposals: Fire and Emergency Services Act 2005 section 105F (or section 56 or 83 (repealed))—Notice to take action to prevent outbreak or spread of fire Person or body who issued notice: Requirements of notice (as stated therein): Food Act 2001 section 44—Improvement notice Name of authorised officer who served notice: Name of authority that appointed officer: section 46—Prohibition order Name of authority or person who served order: Ground Water (Qualco-Sunlands) Control Act 2000 Part 6—Risk management allocation Is a waterlogging and salinity risk management allocation attached to the whole or any part of the land? *YES/NO If YES, give details of the allocation and the land to which it is attached: section 56—Notice to pay share of Trust costs, or for unauthorised use of water, in respect of irrigated property Heritage Places Act 1993 section 14(2)(b)—Registration of an object of heritage significance Date of registration: Description and location of object registered: section 17 or 18—Provisional registration or registration Description of place registered: Has the place been designated as a place of geological, palaeontological or speleological significance or archaeological significance? *YES/NO section 30—Stop order Part 6—Heritage agreement section 38—"No development" order Highways Act 1926 Part 2A—Establishment of control of access from any road abutting the land Date of establishment of control of access: Description of boundary of land affected: Housing Improvement Act 1940 (repealed) section 23—Declaration that house is undesirable or unfit for human habitation Date of declaration: Those particulars required to be provided by a council under section 23: Part 7 (rent control for substandard houses)—Notice or declaration Date of notice or declaration: Those particulars required to be provided by the housing authority under section 60: Housing Improvement Act 2016 Part 3 Division 1—Assessment, improvement or demolition orders Those particulars required to be provided by the Minister under section 14 or 15 (if applicable): section 22—Notice to vacate premises Name of authority that issued the notice: Date by which the premises must be vacated: section 25—Rent control notice Maximum rent payable (per week): Land Acquisition Act 1969 section 10—Notice of intention to acquire Name of Authority who served notice: Description of land intended to be acquired (as described in the notice): Landscape South Australia Act 2019 section 72—Notice to pay levy in respect of costs of regional landscape board section 78—Notice to pay levy in respect of right to take water or taking of water section 99—Notice to prepare an action plan for compliance with general statutory duty section 107—Notice to rectify effects of unauthorised activity section 108—Notice to maintain watercourse or lake in good condition section 109—Notice restricting the taking of water or directing action in relation to the taking of water Water resource to which notice applies: section 111—Notice to remove or modify a dam, embankment, wall or other obstruction or object section 112—Permit (or condition of a permit) that remains in force section 120—Notice to take remedial or other action in relation to a well Location of well: section 135—Water resource works approval Details of site where works are authorised: section 142—Site use approval Details of location where water use is allowed: section 166—Forest water licence Details of location of forest to which licence relates: section 191—Notice of instruction as to keeping or management of animal or plant section 193—Notice to comply with action order for the destruction or control of animals or plants section 194—Notice to pay costs of destruction or control of animals or plants on road reserve section 196—Notice requiring control or quarantine of animal or plant section 207—Protection order to secure compliance with specified provisions of the Act section 209—Reparation order requiring specified action or payment to make good damage resulting from contravention of the Act section 211—Reparation authorisation authorising specified action to make good damage resulting from contravention of the Act section 215—Orders made by ERD Court section 219—Management agreements Requirements of agreement: section 235—Additional orders on conviction Date of conviction: Name of court by which conviction is recorded: Requirements of additional order(s): Land Tax Act 1936 Notice, order or demand for payment of land tax Date of notice, order or demand: Amount payable (as stated in the notice): Local Government Act 1934 (repealed) Local Government Act 1999 Local Nuisance and Litter Control Act 2016 section 30—Nuisance or litter abatement notice Notice issued by: Nature of requirements contained in notice: Metropolitan Adelaide Road Widening Plan Act 1972 section 6—Restriction on building work Does the restriction apply to all of the land? *YES/NO (If NO, give details about the part of the land to which the restriction applies): Mining Act 1971 Mineral tenement (other than an exploration licence) Type of tenement: Terms of tenement: Condition(s) (if any) the tenement is subject to: section 9AA—Notice, agreement or order to waive exemption from authorised operations Date of notice, agreement or order: Description of land subject to notice, agreement or order: Period of waiver: Terms (and condition(s), if any) of notice, agreement or order: section 56T(1)—Consent to a change in authorised operations section 58(a)—Agreement authorising tenement holder to enter land section 58A—Notice of intention to commence authorised operations or apply for lease or licence Description of property subject to notice: Name of person who served notice: Name of person on whom notice was served: section 61—Agreement or order to pay compensation for authorised operations Date of agreement or order: Description of property subject to agreement or order: Terms of agreement or order: section 75(1)—Consent relating to extractive minerals section 82(1)—Deemed consent or agreement Date of consent or agreement: Description of property subject to consent or agreement: Name of owner of the land/tenement holder deemed to have provided consent or agreement: Terms of consent or agreement: Proclamation with respect to a private mine Date of proclamation: Native Vegetation Act 1991 Part 4 Division 1—Heritage agreement section 25C—Conditions of approval regarding achievement of environmental benefit by accredited third party provider section 25D—Management agreement Part 5 Division 1—Refusal to grant consent, or condition of a consent, to clear native vegetation Date of refusal or grant of consent: If consent given, condition(s) (if any) of the consent: Natural Resources Management Act 2004 (repealed) section 97—Notice to pay levy in respect of costs of regional NRM board section 123—Notice to prepare an action plan for compliance with general statutory duty section 134—Notice to remove or modify a dam, embankment, wall or other obstruction or object section 135—Condition (that remains in force) of a permit section 181—Notice of instruction as to keeping or management of animal or plant section 183—Notice to prepare an action plan for the destruction or control of animals or plants section 185—Notice to pay costs of destruction or control of animals or plants on road reserve section 187—Notice requiring control or quarantine of animal or plant section 193—Protection order to secure compliance with specified provisions of the Act section 195—Reparation order requiring specified action or payment to make good damage resulting from contravention of the Act section 197—Reparation authorisation authorising specified action to make good damage resulting from contravention of the Act Outback Communities (Administration and Management) Act 2009 section 21—Notice of levy or contribution payable Type of levy or contribution: Phylloxera and Grape Industry Act 1995 section 23(1)—Notice of contribution payable Planning, Development and Infrastructure Act 2016 section 139—Notice of proposed work and notice may require access Name of person giving notice of proposed work: section 140—Notice requesting access Name of person requesting access: Reason for which access is sought (as stated in the notice): Activity or work to be carried out: section 141—Order to remove or perform work section 142—Notice to complete development section 155—Emergency order section 157—Fire safety notice section 192 or 193—Land management agreement section 198(1)—Requirement to vest land in a council or the Crown to be held as open space section 198(2)—Agreement to vest land in a council or the Crown to be held as open space Part 16 Division 1—Proceedings section 213—Enforcement notice Name of designated authority giving notice: section 214(6), 214(10) or 222—Enforcement order Plant Health Act 2009 section 8 or 9—Notice or order concerning pests Date of Gazette in which notice published (if applicable): Nature of requirement, restriction or prohibition: Public and Environmental Health Act 1987 (repealed) Part 3—Notice Name of council or other authority giving notice: Public and Environmental Health (Waste Control) Regulations 2010 (or 1995) (revoked) Part 2—Condition (that continues to apply) of an approval Name of relevant authority that granted the approval: Public and Environmental Health (Waste Control) Regulations 2010 (revoked) regulation 19— Maintenance order (that has not been complied with) Name of relevant authority giving order: South Australian Public Health Act 2011 section 66—Direction or requirement to avert spread of disease Date of direction or requirement: Name of authority giving direction or making requirement: Nature of direction or requirement: section 92—Notice Name of council or other relevant authority giving notice: South Australian Public Health (Wastewater) Regulations 2013 Part 4—Condition (that continues to apply) of an approval Name of person or body that granted the approval: Upper South East Dryland Salinity and Flood Management Act 2002 (expired) section 23—Notice of contribution payable Amount payable: Water Industry Act 2012 Notice or order under the Act requiring payment of charges or other amounts or making other requirement Name of person or body who served notice or order: Amount payable (if any) as specified in the notice or order: Nature of other requirement made (if any) as specified in the notice or order: Water Resources Act 1997 (repealed) section 18—Condition (that remains in force) of a permit section 125 (or a corresponding previous enactment)—Notice to pay levy Other Caveat Name and address of caveator: Particulars of interest claimed: Lien or notice of a lien Land or other property subject to lien: Nature of lien: Name and address of person who has imposed lien or given notice of it: Charge of any kind affecting the land (not included in another item) Person or body in whose favour charge exists: Nature of charge: Amount of charge (if known): †Schedule 2—Division 2—Other particulars (section 7(1)(b) and section 8(1)(b)) †Particulars of transactions in last 12 months If the vendor, within 12 months before the date of the contract of sale— (a) obtained title to the land; or (b) obtained an option to purchase the land; or (c) entered into a contract to purchase the land (whether on the vendor's own behalf or on behalf of another), the vendor must provide the following particulars of all transactions relating to the acquisition of the interest that occurred within that 12 month period: 1 The name and address of each party to the transaction and of each person in whom an interest vested as a result of the transaction: 2 The date and nature of each instrument registered on the certificate of title or, if no such instrument has been registered, the date and nature of each document forming the whole or part of a contract relating to the transaction: