Fill and Sign the For and in Consideration of the Sum of Dollars Form

STATE OF MISSISSIPPI COUNTY OF _______ BILL OF SALE FOR AND IN CONSIDERATION of the sum of _______________________Dollars ($_______________________), cash in hand paid, receipt of which is hereby acknowledged, _______________________., a Mississippi professional corporation (hereinafter called "Seller"), does hereby convey, sell and warrant title unto _______________________, a Mississippi corporation (hereinafter called "Buyer"), the equipment, furnishings, and supplies described in Exhibit "A" attached hereto and made a part hereof, which equipment, furnishings, and supplies relate to the medical practice at _______________________, _______________________Seller agrees to pay the _______ personal property taxes on said equipment, furnishings, and supplies.By its signature hereon, Buyer acknowledges receipt and acceptance of all of said equipment, furnishings, and supplies in their as is and present condition. WITNESS our signatures, this the _______ day of _______ , _______._______________________Seller By _______________________ ______________________________________________Buyer By: ______________________________________________STATE OF MISSISSIPPI COUNTY OF ______Personally appeared before me, the undersigned authority in and for the said County and State, on this ______ day of ______, ______,within my jurisdiction, the within-named _________________., who acknowledged that he is President of _____________________., a Mississippi professional corporation, and that for and on behalf of said corporation, and as its act and deed, he executed the above and foregoing instrument, after first having been duly authorized by said corporation so to do. _____________________Notary Public My commission Expires: STATE OF MISSISSIPPI COUNTY OF ___________________ Personally appeared before me, the undersigned authority in and for the said County and State, on this ______day of ______, ______,within my jurisdiction, the within-named ______, who acknowledged that he is Executive Director of _____________________., a Mississippi corporation, and that for and on behalf of said corporation, and as its act and deed, he executed the above and foregoing instrument, after first having been duly authorized by said corporation so to do. Notary Public My Commission Expires: