Fill and Sign the Adverse Claim Form

FORM No. 129-M – Uniform Conveyancing Blanks Notice of Adverse Claim on Registered Land (reserved for recording data) NOTICE OF ADVERSE CLAIM ON REGISTERED LAND--BY INDIVIDUAL(S) STATE OF MINNESOTA ) ) ss. COUNTY OF _____________ ) ____________________________________________________________________, Adverse Claimant, (whether one or more) being frst duly sworn on oath says: 1. Adverse Claimant claims an interest adverse to the registered owner in land registered in Volume ____, page _____, Certifcate of Title No. ______________, in ________________ County, Minnesota, described as follows: (If more space is needed, continue on back) 2. The alleged right or interest claimed by Adverse Claimant is as follows: 3. The alleged right or interest was acquired as follows: 4. The residence address of Adverse Claimant is as follows: 5. All notices may be served upon Adverse Claimant at the following address (not a post ofce box): ADVERSE CLAIMANT - 1 - FORM No. 129-M – Uniform Conveyancing Blanks ___________________________________________ ___________________________________________ Subscribed and sworn before me this _______________ day of ________________, 20 _____ ___________________________________________________ SIGNATURE OF NOTARY PUBLIC OR OTHER OFFICIAL THIS INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESS): NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK): - 2 -