Fill and Sign the For Valuable Consideration of Ten Dollars Form

- Quitclaim Deed - Page 1 - This document prepared by (and after recording return to):Name: Firm/Company: Address: Address 2: City, State, Zip: Phone: )))))))--------Above This Line Reserved For Official Use Only------------- QUITCLAIM DEED (Individual to Husband and Wife) KNOW ALL MEN BY THESE PRESENTS THAT: FOR VALUABLE CONSIDERATION OF TEN DOLLARS ($10.00), and other good and valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged, ________________________, an Individual, married unmarried, hereinafter referred to as “Grantor”, does hereby remise, release, and quitclaim unto ________________________ and ________________________, Husband and Wife, as tenants by the entireties, hereinafter “Grantees”, the following lands and property, together with all improvements located thereon, lying in the County of ______________________, State of New York, to-wit: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description: Prior instrument reference: Book _ _____ , P ag e _ _____ , D ocu m en t N o. _ _____ , o f t h e R eco rd er o f ______________________ County, New York.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 Grantees, and unto Grantees’ heirs and assigns forever, with all appurtenances thereunto belonging. - Quitclaim Deed - Page 2 - Grantor, in compliance with Section 13 of the Lien Law, covenants that the Grantor will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. TO HAVE AND TO HOLD to the said Grantees as joint tenants, with right of survivorship, their heirs, personal representatives, executors and assigns forever: it being the intention of the parties to this conveyance, that (unless the joint tenancy hereby created is severed or terminated during the joint lives of the grantees herein) in the event one Grantee herein survives the other, the entire interest in fee simple shall pass to the surviving Grantee, and if one does not survive the other, then the heirs and assigns of the Grantees herein shall take as tenants in common.WIT N ESS G ra n to r h an d(s ) t h is t h e _ ___ d ay o f _ _______________ , 2 0____ . __________________________________Grantor{Type Name} CERTIFICATE OF ACKNOWLEDGMENT Individual Capacity within the State of New York for Real Property State of New York) )ss.: County of )On the day of in the year before me, the undersigned, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Signature and Office of Person Taking Acknowledgement Type/Print Name: Individual Capacity Outside the State of New York for Real Property State of ____________) )ss.: County of )On the day of in the year before me, the undersigned, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by - Quitclaim Deed - Page 3 - his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument and that such individual made such appearance before the undersigned in the EE (insert the city or other political subdivision and the State or country or other place the acknowledgment was taken). Signature and Office of Person Taking Acknowledgement Type/Print Name: Names and address of the Grantor:Name: Address: City/State/Zip: Name and Address of Grantees:Name: Address: City/State/Zip: Name: Address: City/State/Zip: Exhibit APage 1 of 1 EXHIBIT A