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]

Notary Form @ Template.net