A ground rent agreement, made pursuant to the provisions of this article, may be incorporated into the deed or other instrument of transfer in the following form:
This deed is subject to annual ground rent or charge as follows:
1. Date of agreement:
2. Parties:
Obligor —
Obligee —
3. Ground rent and any future adjustments to it:
4. When payable:
5. Duration:
6. Original value of land:
7. Redemption price, if agreed on.
1975, c. 363.