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Declaration Of Homestead For Homes Owned By Natural Persons Form - The Commonwealth Of Massachusetts Page 2

5. I/we, whose names are signed on this document, acknowledge that I/we sign it voluntarily for its stated purpose.

To be signed by Applicant(s) in front of Notary Public.

Signed under pains and penalties of perjury this

_______________________________________________day of _____________________________________________ , 20 ______.

____________________________________________________________________________________________________

For Use by Notary Public Only:

COMMONWEALTH OF MASSACHUSETTS

_______________________________________________, ss.

________________________________________, 20 ______ , before me, the undersigned notary public, personally appeared

____________________________________________________________________________________________________ ,

(name(s) of the document signer(s))

proved to me through satisfactory evidence of identification, which were ___________________________________________ ,

(drivers license, passport, etc.)

to be the person(s) who signed the preceding or attached document in my presence, and who swore or affirmed to me that the contents of

the document are truthful and accurate to the best of (his) (her) (their) knowledge and belief.

Notary Public: ____________________________________________________________________________________________

My commission expires: _____________________________________________________________________________________

Declaration of Homestead for Homes Owned by Natural Persons - Page 2 of 2

Declaration Of Homestead For Homes Owned By Natural Persons Form - The Commonwealth Of Massachusetts Page 2