Declaration Of Homestead For Homes Owned By Trustee(S) - The Commonwealth Of Massachusetts Page 2

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6. Select ONE of the following:
Deed is recorded in __________________________________ Registry of Deeds in ______________ and _______________
(district/county)
(book)
(page)
Certificate of Title _________________ registered in the Land Registration Office ______________ and _______________
(number)
(book)
(page)
Inheritance from _________________________________________________________________________ , Docket number
(name of previous owner)
_______________________________________________ in ________________________________________________.
(number)
(county)
For manufactured homes, license number __________________________________________________________________ .
(number)
7. I/we, the trustee(s) whose name(s) 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 Trustee(s) - Page 2 of 2

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