THE GRANTOR_______________________________________of______________________,
City of_____________________________________,County of____________________,
State of_____________________________,for the consideration of_____________
_______________________________________CONVEY__________and QUIT CLAIM______
to_________________________________of___________________________, City of__
______________, County of______________________, State of_________________,
all interest in the following described real estate in the County of_______
______, in the State of_____________________, to wit:
Dated this____ day of_______,20___.
___________________________________
Grantor's Signature
___________________________________
Type or Print Name
___________________________________
Recipient Signature
___________________________________
Type or Print Name
_______________________________________________________________________________
_______________________________________________________________________________
STATE OF____________________________
COUNTY OF___________________________
I,___________________________________, Notary Public in and for the state of
_____________________________, do hereby certify that on this__ day of______,
20__, personally appeared before me___________________________ known to be the
individual described in and who executed the within instrument and acknowledged
that_____________________________ signed the same as___________________________
free and voluntary act and deed for the uses and purposes herein mentioned.
Given under my hand and official seal this___day of_______20___. Commission
expires_____________20___.
___________________________
Notary Public