ecording requested by (name):
_____________________________ 
When recorded mail to
and mail tax statements to _____________________________ 
_____________________________ 
_____________________________ 
_____________________________ 

DECLARATION OF HOMESTEAD
Assessor’s Parcel No.: ________________________________	Declaration of Exemption From GC § 27388.1 Fee
 Transfer is exempt from fee per GC § 27388.1(a)(2):
     Transfer is subject to Documentary Transfer Tax    
     Transfer of residential dwelling to owner-occupier
 Transfer is exempt from fee per GC 27388.1(a)(1):
     $225.00 fee cap      Not related to real property	
I, _______________________________________, do hereby certify and declare as follows: 
1. 	I hereby claim as a declared homestead the premises located in the City of ______________________, State of California, commonly known as (street address): ________________________________, and more particularly described as follows (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 my principal dwelling. I am currently residing on that declared homestead.
The facts as stated in this Homestead Declaration are known to be true as of my own personal knowledge.

Date: _______________ 	_______________________________________
	(Signature of Declarant)
	_______________________________________ 
	(Print Name)