Declaration of Homestead
______CHECK HERE if you are ELDERLY (62 or older) or DISABLED and are filing this under Massachusetts General Laws chapter 188, section 1A. KNOW ALL MEN BY THESE PRESENTS that I, ______________________________ of _________________________ (city/town), County of _________________________ and Commonwealth of Massachusetts as a householder and having a family and being entitled to an Estate of Homestead in the land and buildings hereinafter described do hereby declare that I own and am possessed and occupy said premises as a residence and Homestead under Massachusetts General Laws, chapter 188 as amended, to wit: DESCRIPTION Street Address: __________________________________________________ Title Reference: Book:__________ Page:__________ Other:__________
Witness my hand and seal this _____ day of ________________, 20___.
______________________________ (signature) COMMONWEALTH OF MASSACHUSETTS On this ____day of ______________20 , before me, personally appeared
________________________________, proved to me through satisfactory evidence of identification, which were________________________________________, to be the person whose named is signed on the preceding or attached documents, and acknowledged to me that they signed it voluntarily for its stated purpose ______________________________ Notary Public(seal) My commission expires:
Commonwealth of Massachusetts
Middlesex North Registry of Deeds
360 Gorham Street Lowell, Massachusetts 01852 www.lowelldeeds.com
Richard P. Howe Jr.
Register of Deeds
Tel. (978) 322-9000 Fax. (978) 322-9001
Instructions for Filing Declaration of Homestead By Mail
The following instructions are provided as a public service and should not be considered legal advice. If you have specific questions about the homestead and your particular situation, please contact an attorney. 1. If you are 62 years of age or older, place a check mark in the place that says "CHECK HERE if you are ELDERLY." This section also applies to a disabled individual, however, the law has a very strict definition of disability. Please refer to Massachusetts General Laws chapter 188, section 1B to determine if you qualify. 2. Print your name, city or town and county of residence, and the street address of your home in the appropriate spaces. 3. Fill in the correct "Title Reference." For those who own recorded land (most homeowners) that is the book and page number of the deed by which you became the owner of the property. These numbers are usually printed on your copy of your deed. You may also look them up on our website or find them on your property tax bill. If you own "registered land" you should write your certificate of title number in the "Other" space. 4. Date and sign the form and have your signature acknowledged by a Notary Public. 5. Mail the completed form, a check for $35 payable to the "Registry of Deeds" and a self-addressed, stamped envelope to Middlesex North Registry of Deeds, 360 Gorham Street, Lowell, MA 01852. 6. If you have any questions, please send an email to email@example.com or call our Customer Service Office at 978/322-9000.