KS Certification of Identifying Information

Certification - KSA 45-221 – Home Address or Home Ownership Identifying Information

Re: Purchase, Sale or Mortgage of Property Name: ______________________________ As described in KSA 45-221 (51) and (52) under HB 2427 with respect to Kansas:

I am not a federal judge, a justice of the supreme court, a judge of the court of appeals, a district judge, a district magistrate judge, the United States Attorney for the District of Kansas, an assistant United States attorney, the attorney general, an assistant attorney general, a district attorney or county attorney or an assistant district attorney or assistant county attorney; or a law enforcement officer as defined in KSA 2011 Supp 21-5111, a parole officer, a probation officer, a court services officer or community correctional services officer.

I understand that this certificate will be relied upon by Stewart Title Guaranty Company and ______________________ for purposes of determining whether a request has been made by or for me to a public agency to have my identifying information of home address or home ownership removed from public access.

Under penalties of perjury, I declare that I have examined this certification and to the best of my knowledge and belief it is true, correct, and complete.

______________________ Date

______________________ Signature

______________________ Signature

No guidelines are available for this form at this time.