RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
NAME
STREET
ADDRESS
CITY, STATE &
ZIP CODE
SPACE ABOVE THIS LINE FOR RECORDER’S USE ONLY
DECLARATION OF HOMESTEAD
I, ___________________________________________________________________________________________________
(
Full Name of Declarant)
do hereby certify and declare as follows:
(1) I hereby claim as a declared homestead the premises located in the City of __________________________________
County of _________________________________________________, State of _______________
commonly known as _____________________________________________________________________________
(Street Address)
and more particularly described as follows: [Give complete legal description]
(2) I am the declared homestead owner of the above declared homestead.
(3) I own the following interest in the above declared homestead:
(4) The above declared homestead is [strike inapplicable clause] my principal dwelling and
the principal dwelling of my spouse
[strike inapplicable clause] I am currently residing on that declared homestead.
my spouse is
(5) The facts stated in this Declaration are true as of my personal knowledge.
___________________________________ _______________________________________________
Date (Signature of Declarant)
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to
which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
* There are various types of homestead forms depending on each person’s legal status. Before you use this form you may want to consult an
attorney if you have questions concerning which document form is appropriate for your transaction.
STATE OF _________________________________
COUNTY OF _______________________________
On ___________________________________ before me, _________________________________________________________ ,
(Date) (Name and title of the officer)
personally appeared __________________________________________________________________, who proved to me on the basis of
(Name of person signing)
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 of officer
(Seal)
