STATE OF MARYLAND)
) to wit:
____________________ COUNTY)
JOHN Q. PUBLIC and NANCY Q. PUBLIC, husband and wife, parties of the second part in the within deed, hereby certify under the penalties of perjury, that the land conveyed in said deed is residentially improved, owner-occupied, real property and that the residence will be occupied only by us.
____________________________________ [Seal]
JOHN Q. PUBLIC
____________________________________ [Seal]
NANCY Q. PUBLIC
WITNESS:
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____________________________________
STATE OF MARYLAND, CITY/COUNTY OF ______________, TO WIT:
I HEREBY CERTIFY, that on this _________ day of ___________, 20______, before me, a Notary Public of the State aforesaid, personally appeared JOHN Q. PUBLIC and NANCY Q. PUBLIC, husband and wife, who acknowledged the foregoing Deed to be their act.
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Notary Public
My Commission Expires: ______________
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