EXAMINER OF TITLES	COUNTY OF HENNEPIN
CPT No. ____
In the Matter of the Application of

____________________________

To Register Possessory Title to Certain Land	EXAMINER’S
CERTIFICATE OF MAILING

Address List of
Persons To Be Given Notice	

STATE OF MINNESOTA	)
				)	ss
COUNTY OF HENNEPIN	)

After a due and diligent search the undersigned hereby certifies that the names and addresses of all persons or parties determined by the examiner to have or claim any right, title, estate, lien or interest in the within described land are as follows: [If a name in the examiner’s report has legally changed, state the name as (current name), f/k/a (name stated in the report).]

Name	Address	

	

	

	

	

	
Additional Pages May Be Attached.
[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”.]

							Applicant/Attorney's Signature

Subscribed and sworn to before me
by 						
this 		 day of 			, 20	

Notary Public

Notary Seal