Fill and Sign the By Names of Persons Form

Prepared by, recording requested by and return to: ---------------------- Above this Line for Official Use Only --------------------- Name: Company: Address: City: State: Zip: Phone: Fax: 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 Seller(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 opt ion is subject to the terms and conditions of that certain option agreement between Seller(s) and Purchaser(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000. ______________________ __________ Seller _____________________________________ Buyer ________________________________ Seller _____________________________________ Buyer STATE OF KANSAS COUNTY OF ___________________ This instrument was acknowledged to me on _______________________________ (date) by ________________________________ [name(s) of person(s)]. ______________________________ Notary Public Print Name: ___________________ My commission expires: ___________________ STATE OF KANSAS COUNTY OF ___________________ This instrument was acknowledged to me on _______________________________ (date) by ________________________________ [name(s) of person(s)]. ______________________________ Notary Publ ic Print Name: ___________________ My 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: