COMMONWEALTH OF MASSACHUSETTS TRIAL COURT LAND COURT DEPARTMENT
CASE NO.
Petition To Amend Certificate of Title
Now comes , of issued by the County;
alleging that they are the registered owner in Certificate of Title No. Registry District of
and further representing that said Certificate of Title was issued subject to
and further representing that
and praying for an amendment so as to expunge therefrom Signed:
Then personally appeared the above-named acknowledged the foregoing instrument to be his/her/their free act and deed, before me,
Notary Public My Commission Expires: FROM THE OFFICE OF: