Fillable FOR RECORDING STAMP DO NOT WRITE IN THIS (Nevada Real Estate Division)

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FOR RECORDING STAMP DO NOT WRITE IN THIS (Nevada Real Estate Division)

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DECLARATION OF HOMESTEAD
FOR RECORDING
STAMP
DO NOT WRITE IN
THIS AREA
Assessor’s Parcel Number (APN):
__________________________________________________________ or
Assessor’s Manufactured Home ID Number:
__________________________________________________________
Recording Requested by and Mail to:
Name: ____________________________________________________
Address: __________________________________________________
City/State/Zip: _____________________________________________
Check One:
Married (filing jointly) Married (filing individually)
Widowed Single Person Multiple Single Persons Head of Family
By Wife (filing jointly for benefit of both) By Husband (filing jointly for benefit of both)
Other (describe): ________________________________________________________________________
Check One:
Regular Home Dwelling/Manufactured Home Condominium Unit Other
Name on Title of Property:
_________________________________________________________________________________________
do individually or severally certify and declare as follows:
_________________________________________________________________________________________
is/are now residing on the land, premises (or manufactured home) located in the city/town of
____________________________, county of ______________________________, State of Nevada, and
more particularly described as follows: (set forth legal description and commonly known street address or
manufactured home description)
_________________________________________________________________________________________
_________________________________________________________________________________________
I/We claim the land and premises hereinabove described, together with the dwelling house thereon, and its
appurtenances, or the described manufactured home as a Homestead.
In witness, Whereof, I/we have hereunto set my/our hands this day of______ , 20______________ ___
________________________________________ ________________________________________
Signature Print or type name here
________________________________________ ________________________________________
Signature Print or type name here
STATE OF NEVADA, COUNTY OF _____________________ This instrument was acknowledged before
me on ____________
(date)
By _________________________________________
_________________________________________
_________________________________________
Person(s) appearing before notary
By
Person(s) appearing before notary
Signature of notarial officer
Notary Seal
CONSULT AN ATTORNEY IF YOU DOUBT THIS FORM FITS YOUR PURPOSE.
NOTE: Do not write in 1-inch margin. Revised Sept. 2019
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FOR RECORDING STAMP DO NOT WRITE IN THIS (Nevada Real Estate Division)

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Completed 28 December 2021

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