Fill and Sign the Considerations the Receipt and Sufficiency of Which is Hereby Acknowledged Each of the below Form

SHORT FORM OF OPTION TO PURCHASE REAL ESTATE (SITE NAME)For and in consideration of ten dollars ($10.00) cash in hand paid and other good and valuable considerations, the receipt and sufficiency of which is hereby acknowledged, each of the below named Sellers hereby grants unto Buyer named below for a period of six (6) months from the date hereof, the exclusive right and option to purchase the real property situated in the County of _______________, _______________, all as more particularly described as: The rights and obligations herein set forth are subject to the terms and conditions set out in Option to Purchase Real Estate (Long Form) related to the above described lands which has been executed by the parties hereto on or before the date hereof, same being incorporated by reference. The long form provides for any necessary easement to public roads and utilities to be included in the deed. This Short Form is recorded to serve as public notice. Notice to Seller of exercise of the Option during the term as provided in said Long Form will convert the option into a contract to purchase and sale, all as more fully set forth therein. The option may also be extended for an additional six months as provided in the Long Form. In the event of conflicts between this document and the Long Form, the Long Form shall control. Witness the hand and seal of the Sellers on this the day of _______________, 20 ___. _____________________________________ Buyer _____________________________________ Seller ACKNOWLEDGMENT STATE OF COUNTY OF Personally appeared before me, the undersigned authority in and for the above county and state, the within named ____________________________ who each acknowledges that each of them signed and delivered the foregoing instrument on the day and year first written above. GIVEN under my hand and seal of office, this day of ______________, 20____. __________________________________ [NOTARIAL SEAL] Notary Public My Commission Expires: