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Dated this .... ....... day of . C` f.�l ........................... 2()()D— <br />On <br />the above date, before we a General Notary Public duly cotmnissioncd and <br />qualified. personally w... . . . ...................... <br />1 <br />. ....... ; .. e,...... .Lx.........n ................ <br />To me known to bgfhridkhtical. person-5,... whose name... affixed to the foregoing <br />inswment as grainos ,•• anll, acIW1wledged die same to he a voluntary act and deed. <br />W ITN S. my WO "dVoLadul y Seal die day and year above written. <br />Notary ....,.... /... � ................:. ............................... <br />My conmrission expires the/t� -,. day of ::{20U# <br />STATE OF ............ ..sue „..':, ";!.C...X.Y.. /....... 1 <br />SS. <br />............................ ............................... COUNTY <br />PLEASE PRINT ALL NAMES <br />Exact and full name of OWNER, as same appears of record <br />200202829 <br />Datedthis ........................... day of ...............................,..... .............................. 2UW <br />On die above date, before me a Oumral Notary Public duly commissioned and <br />qualified, personally come ............................................................ ............................... <br />To the known to be die identical person ....... whose mine....... affixed to die foregoing <br />instrument as granular ........ and acknowledged the same to be a voluntary act and deed. <br />W ffNESS my hand and Notarial Seal the day and year above written <br />Notary..... ............................... '......." <br />Mycousirdasimt expires die ........... day of ......... ............................... 20(X) <br />STATE OF <br />MEMORANDA <br />Ifmarried, full name of spouse ................ ............ .... ... _..__ ............. ... .._._.._........ .... I.- ..._._. <br />Ifunmarried, show "single,” "widower," "widow" ..................... _ ............. ......... ._ ................ <br />_._... <br />If mortgage or other liens, show names of holders, amounts, dates and book page of record <br />If an estate, give the names of all the heirs, with the share of each, Show names of spouses of those married <br />Name of executor or administrator ........ . .............. ................. ......... <br />:... <br />If any of the owners or heirs are minors, give their names and ages <br />Name of guardian <br />TENANT - Exact and full names. Rent Agreement <br />REMARKS <br />I ' _i <br />SS. <br />COUNTY <br />