RECORDING REQUESTED BY:

AND WHEN RECORDED MAIL TO:

NAME
ADDRESS
CITY
STATE & ZIP
APN NO. __________________________________________

DECLARATION of HOMESTEAD

I,_______________________________________________________________________________do
hereby certify and declare as follows:

1. I hereby declare that 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 (strike inapplicable clause)
a)my principal dwelling
b) the principal dwelling of my spouse, and

(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.

Dated__________________       _______________________________________________

STATE OF CALIFORNIA
COUNTY OF ________________________________________} SS
On ___________________________________ before me,________________________________ personally appeared
_______________________________________ personally known to me (or 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.

WITNESS my hand and official seal.

Signature__________________________________________________