COMMONWEALTH OF MASSACHUSETTS

TRIAL COURT

LAND COURT DEPARTMENT

CASE NO. __________________________________

Petition to Amend Certificate of Title by Expunging Mortgage

Upon the complaint of __________________________________________________ representing that

__________________________________________________ are the registered owners in Certificate of Title

No. _________________ issued by the _____________ Registry District of ____________________ County;

and further representing that said Certificate of Title No. ____________________ is encumbered by a

mortgage given to _______________________________________ dated _________________ registered as

Document No. __________________ noted on said Certificate of Title No. ________________ purporting to

secure a Note for $ __________________________ ;

and further representing that said mortgage is undischarged, unassigned, unforeclosed and not legally or

properly discharged;

and further representing that mortgagor or those claiming under him have been in uninterrupted

possession for a period of twenty years after the expiration of the time limited in the mortgage for the full
performance of the conditions thereof;

and praying that said Certificate of Title by amended by striking therefrom all reference to aforesaid

mortgage.

Signed under pains and penalties of perjury.

Name:
Address:

Telephone:

_____________________________
_____________________________
_____________________________
_____________________________

FROM THE OFFICE OF:
___________________________________
___________________________________
___________________________________
___________________________________

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