Homestead Declaration Form - County Of Los Angeles

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Recording Requested By:
When recorded mail document to:
NAME
ADDRESS
CITY
STATE & ZIP
Above Space for Recorder’s Use Only
HOMESTEAD DECLARATION
I, ____________________________________________________________do hereby
certify and declare as follows:
1. I hereby claim as a declared homestead the premises located in the City of _____
___________________, County of Los Angeles, State of California, commonly
known as __________________________________________________ and more
particularly described as follows
2. I am the declared homestead owner of the above-declared homestead.
3. I own the following interest in the above declared homestead:
______________________________________________________________________
The above declared homestead is my principal dwelling and I am currently residing on
that declared homestead.
The facts as stated in this declaration of homestead are known to be true as of my own
personal knowledge.
Dated _________________________
____________________________________
STATE OF CALIFORNIA
}
COUNTY OF LOS ANGELES
} SS
On_______________before me, _____________________________a Notary Public,
personally appeared ___________________________who proved to me on the basis of
satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/their/her
authorized capacity (ies), and that by his/her/their signatures(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
(SEAL)
WITNESS my hand and official seal.
_______________________
NOTARY SIGNATURE

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