Form 10 Sample Determination of Eligibility of Request for Capital Improvement


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NameForm 10 Sample Determination of Eligibility of Request for Capital Improvement
A typeDocumentation



Form 10
Sample Determination of Eligibility of Request for Capital Improvement
Date:___________________
Name of Homeowner____________________________________________________
Address of Home:_______________________________________________________
[Name of Monitoring Agent] has approved your request to consider the following proposed capital improvement as eligible for inclusion in the maximum resale price:



You have estimated the cost of this work at $_____________.
At the time of resale the value of this work will be determined based on the standard rate of depreciation.
________________________________________

Name of Monitoring Agent

Commonwealth of Massachusetts
County of _______________

On this ____ day of________, 20__, before me, the undersigned notary public, personally appeared_____________ proved to me through satisfactory evidence of identification, which was __________ to be the person whose name is signed on the preceding instrument, and acknowledged the foregoing instrument to be his/her free act and deed, in such capacity.
________________________

Name:

My Commission Expires:

Share in:

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