| DECLARATION OF HOMESTEAD (M.G.L. Chapter 188, Section 1) Know all men by these presents that I,___________________________________________ _________________ of _________________________________________________________ County of Bristol and Commonwealth of Massachusetts as a householder, and having a family being entitled to an Estate of Homestead in the land and buildings thereon am filing for protection under Massachusetts General Laws, Chapter 188, and I do hereby declare that I own and am possessed and occupy said hereinafter described premises as a residence and homestead under Massachusetts General Law, Chapter 188 as amended, to wit:
(LEGAL DESCRIPTION)
Witness my hand and seal this_______ day of _____________, 20___.
___________________________ ___________________________
COMMONWEALTH OF MASSACHUSETTS Bristol, ss. On this ________ day of _________________, 20__, before me, the undersigned notary public, personally appeared _____________________________________________, proved to me through satisfactory evidence of identification which were/was _________________________________ to be the person whose name is signed on the preceding or attached document in my presence.
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My commission expires:______________,_____
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