Fill and Sign the Appeared to Me Known to Be the Person Form

Prepared by, recording requested by and return to: Name: Company: Address: City: State: Zip: Phone: Fax: ----------------------Above this Line for Official Use Only--------------------- MEMORANDUM AND NOTICE OF OPTION TO PUCHASE THIS notice is entered into and provided by ________________________________________, "Seller(s) and ______________________________________, “Buyer(s)”, on the date stated below. FOR VALUABLE CONSIDERATION, the receipt and sufficiency of which is hereby acknowledged, Buyer(s) grants to Seller(s) an exclusive option to purchase real property owned by Selle r(s) and located in ________________ County, _____________________, such real property being more fully described as follows: SEE ATTACHED EXHIBIT The option is for a period of __________ ( ) years commencing on _______________________________ and ending on _____________________________. The option is subject to the terms and conditions of that certain option agreement be tween Seller(s) and Purchaser(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000. ________________________________ Seller _____________________________________ Buyer ________________________________ Seller _____________________________________ Buyer STATE OF TENNESSEE COUNTY OF __________________ On this ___________ day of ____________, 20 _________, before me personally appeared _____________________________________________, to me known to be the person (or persons) described in and who executed the foregoing instrument, and acknowledged that such person (or persons) executed the same as such person (or person's) free act and deed. __________________________________ Notary Public Printed Name: ______________________ Commission Expires: _________________ STATE OF TENNESSEE COUNTY OF __________________ On this ___________ day of ____________, 20 _________, before me personally appeared _____________________________________________, to me known to be the person (or persons) described in and who executed the foregoing instrument, and acknowledged that such person (or persons) executed the same as such person (or person's) free act and deed. __________________________________ Notary Public Printed Name: ______________________ Commission Expires: _________________ Seller Name and Address Buyer Name and Address Name: Name: Address: Address: City: City: State: Zip: State: Zip: Phone: Phone: Seller Name and Address Buyer Name and Address Name: Name: Address: Address: City: City: State: Zip: State: Zip: Phone: Phone: