Fill and Sign the Company Existing under and by Virtue of the Laws of the State of and Having Form

- Quitclaim Deed - Page 1 - This document prepared by (and after recording return to): ) ) ) ) ) ) ) ) ) ) -------- Above This Line Reserved For Official Use Only------------- Name: Firm/Company: Address: Address 2: City, State, Zip: Phone: QUITCLAIM DEED (Individual to LLC) This Instrument was filed for record on the ______ day of ______________________, A.D., 20 ______, at ______ o’clock ______ M., and duly recorded in book ______ of Deeds, at page ______. ______________________ Register of Deeds By ______________________ Deputy FEES Register of Deeds, for recording, $ ______________________ County Clerk, for Transfer ______________________ Total, $ ______________________ Entered in Transfer Record in my office ______ day of ______, A.D., 20___. ______________________ County Clerk - Quitclaim Deed - Page 2 - THIS INDENTURE, Made this ______ day of ______ A.D. 20___, between ______________________, an Individual, unmarried married, of ______________________ County, hereinafter referred to as “Grantor”, and ______________________, a Limited Liability Company existing under and by virtue of the laws of the State of ______________________, and having its principal place of business at ______________________ County of ______________________, in the State of ______________________ , hereinafter referred to as “Grantee”; WITNESSETH that Grantor, for the sum of Ten Dollars ($10.00) convey and quitclaim to Grantee, all the following described real estate in the County of ______________________, and the Sta te of Kansas, to-wit: Describe Property of State "SEE DESCRIPTION ATTACHED" Prior instrument reference: Book ______, Page ______, Document No. ______, of the Recorder of ______________________ County, Kansas. LESS AND EXCEPT all oil, gas and minerals, on and under the above described property owned by Grantor, if any, which are reserved by Grantor. SUBJECT to all easements, rights-of-way, protective covenants and mineral reservations of record, if any. TO HAVE AND TO HOLD same unto Grantee, and unto Grantee’s assigns forever, with all appurtenances thereunto belonging. IN WITNESS WHEREOF, this deed was executed by the undersigned on this the ____ day of __________________, 20___. __________________________________ Grantor {Type Name} - Quitclaim Deed - Page 3 - STATE OF ______________________ COUNTY OF _________________ BE IT REMEMBERED, That on this ______ day of __________________ A.D. 20___ before me, the undersigned, a Notary Public in and for said County and State, came __________________ who is/are personally known to me to be the same person(s) who executed the within instrument of writing, and duly acknowledged the execution of the same. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal the day and year last above written. ______________________________ Notary Public, State of Kansas My commission expires: _____________________ Grantor(s) Name, Address, phone: Grantee(s) Name, Address, phone: SEND TAX STATEMENTS TO GRANTEE