UCC-13 RECREATIONAL CABIN AFFIDAVIT

UCC RECREATIONAL CABIN AFFIDAVIT

This form may be utilized to satisfy one of the conditions for excluding a recreational cabin from the construction requirements of the UCC, as provided for in Act 92 of 2004. It should be filled out completely and submitted to the municipality in which the cabin will be constructed. Submission of this form does not satisfy all the requirements of the Act related to this UCC exclusion. If you don’t have the Tax Parcel ID Number, call the county property assessment office.

Upon form completion you will need to print out the form to be signed by a notary. (signature lines included in printable pdf form)

Cabin Construction Site

Address

Street Number & Name City State / Province / Region ZIP / Postal Code

Cabin Owner Information

Owner Name(Required)

Address(Required)

Street Number & Name City State / Province / Region ZIP / Postal Code

Phone

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Agreement

By signing this statement in the presence of a notary public, I attest to the fact that the cabin to be constructed at the site listed above:
<ol>
 	<li>Will be utilized for recreational activities only.</li>
 	<li>Will not be utilized as a domicile or residence by myself or any other person for any period of time.</li>
 	<li>Will not be used for any commercial purposes.</li>
 	<li>Will not exceed two stories in height (excluding the basement, if any).</li>
 	<li>Will not be used as a place of employment.</li>
 	<li>Will not be a mailing address for bills or correspondence.</li>
 	<li>Will not be listed as any individual’s place of residence on a tax return, driver’s license, vehicle registration or voter registration.</li>
</ol>

<table width="100%" style="margin:50px 0px 0px 0px">
 <tr>
 <td>_____________________________________
 Owner Signature</td>
 <td>_____________________________________
 Date</td>
 </tr>
</table>
<table width="100%" style="margin:50px 0px 0px 0px">
 <tr>
 <td>_____________________________________
 Notary Name</td>
 <td>_____________________________________
 Date Commission Expires</td>
 </tr>
</table>

Email(Required)

File

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