STATE OF _________(1)________)

) ss:

COUNTY OF ________(2)________)

KNOW YE ALL MEN BY THESE PRESENTS,

That, ________(3)__________, of ____________(4)______________, for and in consideration of payment of the sum of $_____(5)_____, the receipt of which is hereby acknowledged, do hereby grant, bargain, sell and convey to ___________(6)____________ of

______________(7)________________, and his heirs, executors, administrators, successors and assigns the following property:

(Description of Property)

I hereby warrant that I am the lawful owner of said property and that I have full legal right, power and authority to sell said property. I further warrant said property to be free of all

encumbrances and that I will warrant and defend said property hereby sold against any and all persons whomsoever.

IN WITNESS WHEREOF, I, the seller, have hereto set my hand and seal this _(8)_ day of _____(9)_______, 19_(10)_.

______________(11)_____________

STATE OF ________(12)___________)

) ss:

COUNTY OF _______(13)___________)

On this _(14)_ day of _______(15)________, 19_(16)_, before me personally came and appeared _________(17)___________, known, and known to me, to be the individual described in and who executed the foregoing instrument, and who duly acknowledged to me that he

executed same for the purpose therein contained.

IN WITNESS WHEREOF, I hereunto set my hand and official seal.

_____________(18)______________

My Commission Expires: _________(19)___________