{Reserved for Recording data by county here}
Remove all writing here before printing

_____________________________________________________________________
Your Name(s)© Acceptance of Declaration of Land Patent

Your County COUNTY RECORDING DISTRICT

JOHN DOE, Marital Status, FOREIGN GRANTOR                  	John Doe, American State Grantee

Certificate of Acceptance of Declaration of Land Patent….Pages 2-4
Exhibit A …. Warranty Deed …. Pages 4-6
Exhibit B …. Summary Chain of Title …. Page 7-9
Exhibit C …. Notice to Contact …. Page 10
Exhibit D…. Certified Patent Number XXXX ….Page 11
Exhibit E.... Affidavit of Publishing .... Page 12

Grantor Affirms there are no wells on the property

Drafted by and Return to: 

John Doe and Jane Doe
c/o Your address
your town, Minnesota [55422]

This cover sheet has been added to these recorded documents to provide space for the recording data.
This cover sheet appears as the first page of the document in the official public record.
Do not detach