RECORDING REQUESTED BY



RECORDING REQUESTED BYAND WHEN RECORDED MAIL TOHOMESTEAD DECLARATIONI, _______________________________________________, hereby certify and declare: a) I hereby claim as a declared homestead the premises described as follows: (b) I am the declared homestead owner of the above-declared homestead. (c) I own the following interest in the above-declared homestead: ___________________________________. (d) The above-declared homestead is _________________ (my principal dwelling or the principal dwelling of my spouse), and ________________________________ is currently residing in that declared homestead. (e) My further act of causing this declaration to be recorded shall constitute a representation that ___________________________ reside(s) in the above-declared homestead on the date this declaration is recorded. (f) The facts stated in this Declaration are true as of my personal knowledge. Dated: _________________ ________________________________________State of California County of ________________________________________ On __________________before me, 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/her/their authorized capacity(ies), and that by his/her/their signature(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. WITNESS my hand and official seal. Signature ____________________________________________ (Seal) ................
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