Free DECLARATION OF HOMESTEAD - Massachusetts

DECLARATION OF HOMESTEAD FOR ELDERLY PERSONS KNOW ALL MEN BY THESE PRESENTS THAT I/We,__________________________________ ____________________________________(Name/s) of _______________________(City or Town) COUNTY OF WORCESTER AND COMMONWEALTH OF MASSACHUSETTS as a homeowner and being entitled to an Estate of Homestead in the land and buildings hereinafter described, am filing for protection as an elderly person, I/we do hereby declare that I/we utilize said premises as my/our principal residence under Massachusetts General Laws, Chapter 188, as amended to wit: Property Location: __________________________________________________________ (Street address, City and Zip Code) Deed Reference: Book ________ Page ________ Witness my hand and seal this ___________________ day of _______________, 20___ _______________________________________ _____________________________________

COMMONWEALTH OF MASSACHUSETTS Worcester, SS. Date ____________________

On this day before me, the undersigned notary public, personally appeared _________________ ____________________________________________, proved to me through satisfactory evidence of identification, which were _______________________________, to be the person/s whose name/s are signed on the above document, and acknowledged to me that he/she/they signed it voluntarily for its stated purpose. ________________________________________ Notary Public My Commission Expires: