THE GRANTOR,___________________________________ 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 situated in the County of _______________________________, in the State of __________________________, to wit:
Dated this _____________ day of (mo.)________________________, (yr.)________.
Grantor's Signature
Type or print name
Grantor's Signature
(Print or type name)
STATE OF
COUNTY OF
I, ___________________________________, Notary Public in and for the state of ________________, do hereby certify that on this (mo.)________ day of (mo.)_______________, (yr.)________, 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 (mo.)___________________, (yr.) ______.
Commission expires (mo./day)______________________________, (yr.) ______.
Notary Public