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