CPT No.
In the Matter of the Application of / APPLICATIONfor Certificate
of Possessory Title
To Register Possessory Title to Certain Land
STATE OF MINNESOTA / )
) ss.
COUNTY OF / )
I/We hereby apply to register the possessory title to the land described below pursuant to Minnesota Statutes Chapter 508A and solemnly swear that I/we know the contents of this Application are true of my/our own knowledge except as to those matters stated on information and belief, and that as to those matters I/we believe them to be true.
Cross out all paragraphs or words not applicable.
A.Name(s):and
Address(es):
I/We am/are 18 years of age or older.
OR
I/We am/are not 18 years of age.
List applicants who are not 18 years of age:
B.I/We am/are not married.
OR
is married to
who resides at and is married to who resides at
AND
is married to
who resides at
Cross out all paragraphs or words not applicable.
I/We have not been divorced.
OR
If an applicant has been divorced, please include the following information:
State where divorce was obtained:
County where divorce was obtained:
Court File No.
Date of Decree
I/We am/are not under any legal incapacity except for:
If none, state "None".
C. Description of land (if description is lengthy, you may attach an exhibit):
D. The estimated market value of the land to be registered, exclusive of buildings and/or improvements, according to the last official assessment is $ .
E. Estate or interest claimed in the land is fee simple and is subject to homestead.
OR
Estate or interest claimed in the land is fee simple and is not subject to homestead.
F. The names and addresses of all persons or parties, except the applicant, who appear of record, or who are known to the applicant to have or claim any right, title, estate, lien or interest in the abovedescribed land:
Name / Address / Nature & Character of ClaimIf, after due and diligent search, applicant cannot ascertain the address of one or more of the parties named above, address may be given as "Unknown".
G. The land is unoccupied.
OR
The land is occupied by the following parties:
Name / Nature of Estate or InterestH. There are the following liens and encumbrances on the land, recorded or unrecorded:
Name of Claimant / Address / Character, Amount &Recording Data
If, after due and diligent search, applicant cannot ascertain the address of one or more of the parties
named above, address may be given as "Unknown".
I/We hereby further state that I/we am/are the record owner(s) of the land and am/are in actual or constructive possession of it.
WHEREFORE, I/we request that the Examiner of Titles issue a report finding that I/we hold a possessory estate in the land herein described, as defined in Minnesota Statutes Section 508A.01, Subd. 3.
Signature(s) of Applicant(s)
Subscribed and sworn to before me on this_____ day of______, 20_____ / Subscribed and sworn to before me on this
_____day of______, 20_____
By______
Applicant / By ______
Applicant
Notary Public Notary Public
Notary Seal / Notary SealApplicant(s) or Attorney for Applicant(s): / Approved for Filing:
Address:
Telephone: / Deputy Examiner of Titles
Fax No.: