Trial Court of Massachusetts
Land Court Department
3 Pemberton Square, 5th floor
Boston, MA 02108
(617) 788-7470
NOTICE OF VOLUNTARY
WITHDRAWAL OF LAND
from the Registration System
(G.L. c. 185, § 52)
CASE NUMBER
COURT USE ONLY
LCSBQ-VWD-NOT (11-2018) www.mass.gov/courts/landcourt
Printed: 11/21/2018 5:29:03 PM
Page 1 of 1
The owners of the fee simple estate in all of a parcel of land that has been registered under G. L. Chapter 185
withdraw the land from the provisions of § 52 of Chapter 185.
The land withdrawn is described in Certificate of Title No. in Book , at Page
issued from the Registry District of
County,
shown on Land Court Plan No.
as follows:
all of the land described in the certificate of title.
part of the land described in the certificate of title, namely:
The description of the land in the form contained in the certificate of title is attached hereto as Exhibit A.
The street address (if any) of the land is:
DATE SIGNED:
SIGNATURE OF OWNER
X
PRINT NAME (FIRST, MIDDLE, LAST)
STREET ADDRESS
CITY/TOWN STATE ZIP CODE
SIGNATURE OF OWNER
X
PRINT NAME (FIRST, MIDDLE, LAST)
STREET ADDRESS
CITY/TOWN STATE ZIP CODE
COMMONWEALTH OF MASSACHUSETTS
SS: ____________________________ Dated: ____________________________
Then personally appeared the above-named _______________________________________________________________,
and acknowledged the foregoing instrument to be their free act and deed, before me
X
SIGNATURE OF NOTARY PUBLIC
My Commission Expires: _________________________________
LAND COURT ENDORSEMENT
Pursuant to G. L. c. 185, § 52, the Court approves the Voluntary Withdrawal from the registration system of the
land described above, subject to all registered rights outstanding as of this date.
DATED
X
JUSTICE
