In order to secure the benefit of the exemptions of real estate under §§ 34-4 and 34-4.1, the householder, by a writing signed by him and duly admitted to record, to be recorded as deeds are recorded, in the county or city wherein such real estate or any part thereof is located or, if such property is located outside of the Commonwealth, in the county or city in the Commonwealth where the householder resides, shall declare his intention to claim such benefit and select and set apart the real estate to be held by the householder as exempt, and describe the same with reasonable certainty, affixing to the description his cash valuation of the estate so selected and set apart. Equitable as well as legal estates may be so selected and set apart. The following form, or one which is substantially similar, shall be used and shall be sufficient for the writing required by this section:

HOMESTEAD DEED FOR REAL PROPERTY

Name of Householder ___________________________________________________________________________

Name of title holder of record (if different) ___________________________________________________________________________

Is the householder a disabled veteran entitled to claim the additional exemption under § 34-4.1? ___________________________________________________________________________

Address of Householder ___________________________________________________________________________

Name(s) and age(s) of dependent(s) ___________________________________________________________________________

County/city/state in which real property claimed as exempt is located ___________________________________________________________________________

___________________________________________________________________________

Description of property claimed as exempt ___________________________________________________________________________

___________________________________________________________________________

Value of property described above ___________________________________________________________________________

Number of homestead deeds that have been filed by the Householder

___________________________________________________________________________

Exemption amount previously claimed on prior homestead deeds

___________________________________________________________________________

List the jurisdictions where previous homestead deeds were filed

___________________________________________________________________________

____________________________________ (Signature of Householder)

____________________________________ [ACKNOWLEDGMENT]

Such writing or deed shall not be required to secure any exemption under this Code except those exemptions created by §§ 34-4 and 34-4.1.

Code 1919, § 6532; 1990, c. 942; 1993, c. 150; 1998, c. 331; 2008, c. 224; 2019, c. 492.