Declaration of Homestead

RECORDING REQUESTED BY:

AND WHEN RECORDED MAIL TO:

NAME:

ADDRESS:

CITY: STATE & ZIP:

APN:

HOMESTEAD DECLARATION

I,

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 California, 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: (check applicable boxes)

and

(5) The facts stated in this Declaration are true as of my personal knowledge.

I declare under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct.

Dated:

State of California

County of

On before me,

title of the officer), personally appeared

who proved to me on the basis of 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.