NOTARIAL RECORD - RESIDENTIAL REAL PROPERTY TRANSACTIONS
Date Notarized:
Fee: $
The undersigned grantor hereby certifies that the real property identified in this Notarial Record is Residential Real Property as defined in the Illinois Notary Public Act.
Grantor's (Signer's) Printed Name:
Grantor's (Signer's) Signature:
Grantor's (Signer's) Residential Street Address, City, State, and Zip:
Type or Name of Document of Conveyance:
PIN No. of Residential Real Property:
Common Street Address of Residential Real Property:
Thumbprint or Fingerprint:
Description of Means of Identification:
Additional Comments:
Name of Notary Printed:
Notary Phone Number:
Commission Expiration Date:
Residential Street Address of Notary, City, State, and Zip:
Name of Notary's Employer or Principal:
Business Street Address of Notary's Employer or Principal, City, State, and Zip:
5 ILCS 312/3-102