Free Plymouth Registry of Deeds - Massachusetts

DECLARATION OF HOMESTEAD
Standard Form

I, __________________________________________owning and occupying as a principal residence the property at ___________________________________________________ in
(Street

Address)

____________________________________Plymouth County, Massachusetts, acquired by
(City/Town)

( )

inheritance from ________________________________________ ________________ Probate Court # ________________________

( )

deed from _____________________________________________ dated _______________ and recorded in Plymouth County Registry of Deeds, Book __________ Page __________

( )

Certificate of Title # ________________. LOT(S) ____________ on Plan No. ________________ filed with Certificate of Title No. _____________ in Plymouth County Registry of Deeds, Land Court Division

hereby declare a homestead in said premises under the provisions of Chapter 188, Section 1, of the General Laws of Massachusetts. Executed as a sealed instrument this _____ day of _______________, 20_____

Signature Print Name

____________________________ ____________________________

Return to:

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Plymouth County Registry of Deeds50 Obery St, Plymouth, MA 02360 ­ John R. Buckley, Jr., Register Tel: 508-830-9200 or regdeeds.co.plymouth.ma.us

Commonwealth of Massachusetts ss. County of Plymouth

On this the _______ day of _______________, ___________, before me,
Day Month Year

__________________________________, the undersigned Notary Public,
Name of Notary Public

personally appeared _________________________________________________
Name(s) of Signer(s)

proved to me through satisfactory evidence of identity, which was/were __________________________________________________________________
Description of Evidence of Identity

to be the person(s) whose name(s) is/are signed on the preceding or attached document, and acknowledged to me that he/she/they signed it voluntarily for its stated purpose(.) as partner(s) for _________________
Name of Partnership

___________________________, a partnership. as __________________________________ for
Title of Office

___________________________, a corporation.
Name of Corporation

as attorney in fact for _____________________ ___________________________, the principal.
Name of Principal Signer

as______________________, for ___________
Type of Capacity

____________________, a/the _____________.
Name of Person/Entity Type of Entity

_______________________________________
Signature of Notary Public

_______________________________________
Printed Name of Notary Place Notary Seal and/or Any Stamp Above My Commission Expires

_________________

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Plymouth County Registry of Deeds50 Obery St, Plymouth, MA 02360 ­ John R. Buckley, Jr., Register Tel: 508-830-9200 or regdeeds.co.plymouth.ma.us