Declaration Of Homestead For Homes Owned By Trustee(S) - The Commonwealth Of Massachusetts
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The Commonwealth of Massachusetts
William Francis Galvin, Secretary of the Commonwealth
Declaration of Homestead for Homes Owned
by Trustee(s)
(General Laws Chapter 188)
I, ________________________________________________________ , Trustee
1.
(insert name of owner)
We, ______________________________________________________________,
(insert name of owners)
__________________________________________________________, Trustees
of certain trust _____________________________________________________
(trust name)
_________________________________________________________________,
dated _______________ and recorded ________________and________________
(date)
(book)
(page)
hereby declare homestead pursuant to M.G.L. c.188 and state that I/we own the home
described below and which the beneficiaries listed herein occupy or intend to occupy
as his/her/their principal residence:
Beneficiary Information
2. Enter beneficiary name(s):
_____________________________________________________________________________________
(insert beneficiary name(s))
3. Check all that apply and enter beneficiary name(s):
________________________________________________________________________is/are elderly (62 years of age or older).
(insert beneficiary name(s))
_____________________________________________________________________________________________________
(insert beneficiary name(s))
is/are disabled (have a physical or mental impairment that meets the disability requirements for Supplemental Security Income
under 42 U.S.C. 1382c(a)(3)(A) and 42 U.S.C. 1382c(a)(3)(C). One of the following must be attached: 1) an original or certified
copy of a disability award letter issued to the person by the United States Social Security Administration, or 2) a letter signed by a
physician registered with the board of registration in medicine certifying that each person meets the disability requirements stated
in 42 U.S.C. 1382c(a)(3)(A) and 42 U.S.C. 1382c(a)(3)(C).
I/we, _________________________________________________________________________________________________
(insert name (s))
am/are servicemember(s) who may be subject to protection under the servicemember(s) Civil Relief Act, 50 U.S.C. 553, should I/we
be called to active duty.
4. For each applicable beneficiary, complete one statement. Attach additional page(s) as necessary.
__________________________________________ is married to ________________________________________________
who is not a co-owner of the home but who occupies or intends to occupy the home as his/her principal residence.
__________________________________________ is married to ________________________________________________
who is not a co-owner of the home but who occupies or intends to occupy the home as his/her principal residence.
Home Information
5. Address: ______________________________________________________________________________________ , Massachusetts.
(street number and name, city/town)
(over)
Declaration of Homestead for Homes Owned by Trustee(s) - Page 1 of 2
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