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3 <br />Dated this .... � ...................... day of 1111 ..v�- ug Q............... ......................... -;itlam <br />On the above dale, before me a General Nota 1 Ec duly cormniuioncd and <br />qualified. personally Collie <br />� ...................................... ........................... I .................. I...... <br />........................................... ............................... <br />. ar.+iE.fiYec••.TJa•[. ' .....::............................... .......... ..» ......... 1. ........... .... 11,11........ <br />To the blown to be the Identical person 1111... whore name....... affixed to the foregoing <br />instrument a for . acknowledged the same to be a voluntary act sold deed. <br />I <br />W N and NowW Seal We day amt year above written, <br />Notary . .................................................................. . ............................... <br />My car ' slon axpiro wha ».,......,. day of ........ ... » ..:........................ ;'49tl92CbZ <br />STATE OF. . N4.„-?... KF. l .... ............................... <br />20020`841 <br />Datedt is ........................... day of ..................................... ............................... 20W <br />On the above date, before me. a General Notary Public duly commissioned and <br />qualified, personally carrre ............................................................ ............................... <br />To toe (mown to be the Wended person ....... whose rrartte....... affixed to did foregoing <br />instrument as gramor........ and acknowledged the same W be a voluntary act and deed. <br />Ndaq <br />WITNESS my head and Notarial Set the day and year above written. <br />Mycamntation expires the ............ day of .......... ............................... 2W <br />STATE OF <br />/uI / SS. SS. <br />....,., ,....1,•.`G..�.1 ............... ......................... COUNTY .......I........:. ... COUNTY <br />6ENEEtAlN k GGSMt y.lA'N oa' <br />H - MY Comm. ExP� <br />M�LORANDA <br />PLEASE PRINT ALL NAMES <br />Exact and full name of OWNER, as same appears of record <br />If married, full name of spouse ....................... ... .._ ............. ... _ ........ _ .......... _._ .... ..__ ... _ ........... _.._.. <br />Ifunmarried. show "single,,, "widower," "widow" ...... _ .... _ .... _ .......................... _._........_...._........ <br />If mortgage or other liens, show names of holders, amounts, data and book page of record <br />If an estate, give the names of all the heirs, with the share of each, Show notice of spouses of those married <br />.......... 11.........1.1 ................. _.1111... _ ........ .. <br />Name of executor or administrator <br />If any of the owner or heirs are minors, give their names and slice <br />Name of guardian <br />TENANT • Exact and full names. Rent Agreement <br />REMARKS <br />r 2 i <br />