Housing Exemption Notary Form
Housing Exemption Notary Form
I. Personal Information
Name: [Your Name]
Address: [Your Company Address]
Email Address: [Your Email]
Phone Number: [Your Company Number]
II. Property Information
Property Address: [Property Address]
Owner's Name: [Property Owner's Name]
Legal Description of Property: [Legal Property Description]
III. Exemption Information
Type of Exemption Requested: [Type of Exemption]
Reason for Exemption Request: [Reason for Exemption]
Date of Exemption Request/Grant: [Insert Date]
IV. Certification
I, [Your Name], certify that the above information is true and correct to the best of my knowledge and belief.
[Your Name]
[Insert Date]
V. Notary Acknowledgement
State of [Your State], County of [Your County], I, [Your Name], a Notary Public, do hereby certify that on this day, [Date], [Your Name] appeared before me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed.
Notary Public Name: [Your Company Name]
Notary Seal: [Notary Seal]
Date of Expiry of Commission: [Expiry Date]
