Declaration Legal Form (PDF)

Exactly as extracted, unformatted — for checking against the original. The readable version is easier to read.

DECLARATION OF ADMINISTRATIVE SUBDIVISION
THIS DECLARATION made this _____ day of __________________ 20 ___ by
____________________ and _________________________ (hereinafter the “Declarant(s)”) and
___________________ and _________________________(hereinafter the “Mortgagee(s)”) and
____________________ and _________________________(hereinafter the “Trustee(s)”).
WITNESS:
WHEREAS, the Declarant(s) is or are the fee simple owner(s) of all those lots, parcels,
or tracts of land located in the ___ Election District of Queen Anne’s County, more particularly
known as Map _____, Grid _____, Parcel ____, Lots _____, _____, _____, _____ and _____,
Block _____, _____________________________, as described in a deed or deeds dated
________________________ recorded among the Land Records of Queen Anne’s County at
Liber _____, Folio _____ and Liber _____, Folio _____, and
WHEREAS, said lots are set forth and depicted on a plat know as
____________________, plat _____, section _____, dated ____________________, recorded
among the Land Records of Queen Anne’s County at Plat Book ______, Folio ______ ,and
WHEREAS, said lots are contiguous and share a common boundary lines(s) _____ in
length along a course set forth on the aforesaid plat as ______________________________, and
WHEREAS, the Declarant(s) desires to eliminate the common boundary line(s) between
the said lots for the purpose of combining the lots into on (1) lot of record, and
NOW THEREFORE, in light of the premises and for no consideration, the Declarant(s)
declares and agrees as follows:
1. The above recitals are not merely prefatory but are incorporated herein as if fully
set forth.
2. The Declarant(s) declares that for all purpose other than the payment of fees or
charges imposed by any covenants, agreements, or community association by-law
generally affecting or running with and binding lands within ________________,
the common boundary line(s) between lots _____, _____, _____, and _____,
block _____, _____________________, being _____’ in length is abolished, null
and void, and of no further force and effect with the direct and intended result that
lots _____, _____, _____, and _____, block , _________________________,
shall no longer be separate and distinct lots, but henceforth shall be treated,
considered, granted and conveyed collectively as one (1) lot to be known as lot
_____, block _____, ___________________________.
3. The Declarant(s) expressly acknowledges that after final approval of this
Declaration by the Director of Planning & Zoning, the word “lot” as applied to

any land described in the Declaration shall be deemed for purposes of any zoning
or subdivision ordinance to mean the resulting lot _______ established herein.
4. The Mortgagee(s) or Trust(s) (on behalf of the Beneficiary) is the holder of a lien
on lots _____, _____, _____, and _____, block _____, _____________________
by virtue of a Mortgage/Deed or Trust dated _____________________, 19 _____
and ________, 19 _______, and recorded among the Land Records of Queen
Anne’s County at Liber _____, _____, Folio _____, and Liber _______, ______,
Folio _____ and joins in the executive of this Declaration for itself, it successors
and assigns, for the purpose assenting to the operation and effect of this
instrument.
WITNESS the hands and seals of the Declarant(s), Mortgagee(s)/Beneficiary and/or Trustee(s)
as of this day of , 20 .
WITNESS: DECLARANTS(S)
____________________________ ___________________________________(SEAL)
Signature
___________________________________
Print Name
____________________________ ___________________________________(SEAL)
Signature
___________________________________
Print Name
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_________________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________

STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________

WITNESS: TRUSTEE(S)
____________________________ ___________________________________(SEAL)
Signature
___________________________________
Print Name
____________________________ ___________________________________(SEAL)
Signature
___________________________________
Print Name
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________

STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_______________________________________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________
MORTGAGEE/BENEFICIARY
___________________________ ___________________________________(SEAL)
___________________________ By:________________________________(SEAL)
STATE OF MARYLAND, __________________________, COUNTY TO WIT:
I HEREBY CERTIFY that on this _____ day of _______________, 20____, before me,
the undersigned Notary Public of the State and County aforesaid, personally appeared
_____________________________________________, known to me (or satisfactorily proven)
to be the person whose name is subscribed to the within instrument and acknowledged that
she/he executed the same for the purpose therein contained.
IN WITNESS WHEROF, I have hereunto set my hand and official seal the day and year
last above written.
Notary Public: ________________________________
My Commission Expires: _______________________
MORTGAGEE/BENEFICIAY
_______________________________ _____________________________(SEAL)
_______________________________ BY: _________________________(SEAL)

APPROVED AS TO FORM AND SUFFICIENCY:
Declaration No.: ______________________
Date:________________________________ ____________________________________
Michael Wisnosky, Director,
Queen Anne’s County Department of
Planning & Zoning
Date:________________________________ ___________________________________
Christopher F. Drummond, Esquire
Queen Anne’s County Department of
Planning & Zoning
I hereby certify that I prepared the within instrument and that I am a party to the within
instrument.
______________________________________
Signature
______________________________________
Print Name
______________________________________
Member