A ground rent agreement made pursuant to the provisions of this chapter may be incorporated into the deed or other instrument of transfer in the following form:

1. 1. Date of agreement: ______;

2. 2. Parties:

   1. a. Obligor: ______; and
   2. b. Obligee: ______;
3. 3. Ground rent and any future adjustments to it: ______;
4. 4. When payable: ______;
5. 5. Duration: ______;
6. 6. Original value of land: ______; and
7. 7. Redemption price, if agreed on: ______.

This deed is subject to annual ground rent or charge as follows:

1975, c. 363, § 55-79.06; 2019, c. 712.