Fill and Sign the Grantees Address Form

GRANTEE’S ADDRESS: XXX 100 E. Main St. Richmond, VA 23228THIS DEED GIVEN PURSUANT TO A PROPERTY SETTLEMENT AGREEMENT PURSUANT TO 58.1-806B OF THE CODE OF VIRGINIA, dated this _______ day of ____________, 2004, by and between YYY, divorced, and XXX, divorced, Grantors, and XXX, divorced, as Grantee. RECITALS: This conveyance is exempt from recordation taxes pursuant to section 58.1-811(D) of the Code of Virginia (1950), as amended. CONVEYANCE: This is a deed of gift from the Grantors to the Grantee, wherein the Grantors do hereby quitclaim, release and convey to the Grantee all right, title and interest of the Grantors in and to the following described real estate: [Legal Description] IT BEING the same property conveyed to YYY and XXX, his wife, by deed from JAMES G. SMITH and MARGARET A. SMITH, his wife, dated DDD, duly recorded DDD, in the Clerk’s Office, Circuit Court of Henrico County, Virginia, in Deed Book ____, at page ____. PROVIDED, HOWEVER, that this conveyance is made subject to the terms and conditions of deed of trust dated DDD and recorded in the Clerk’s Office of the Circuit Court of Henrico County, Virginia, in Deed Book 2591, page 593, between YYY and XXX, his wife, and Walter L. Hooker of the City of Richmond, Virginia and Judson W. Collier, Jr., of the County of Henrico, Virginia, as Trustees, conveying the real estate hereinabove described to secure the payment of the principal sum of Fifty Thousand Dollars ($50,000.00), plus interest. The Grantee hereby assumes the aforesaid balance and agrees to perform all the obligations of the said deed of trust. PROVIDED, HOWEVER, that this conveyance is also made subject to the terms and conditions of a second deed of trust dated November 6, 2001, and recorded in the Clerk’s Office of the Circuit Court of Henrico County, Virginia, in Deed Book 3172, page 715, between YYY and XXX, his wife, and Tonja N. Ewing, of Woodbridge, Virginia, as Trustee, conveying the real estate hereinabove described to secure the payment of the principal sum of Twenty Five Thousand Dollars ($25,000.00), plus interest. The Grantee hereby assumes the aforesaid balance and agrees to perform all the obligations of the said deed of trust. The Real Estate is conveyed subject to all recorded easements, conditions, restrictions and agreements that lawfully apply to the Real Estate or any part thereof. Witness the following signature and seal: _________________________(SEAL) YYY (Grantor) _________________________(SEAL) XXX (Grantor and Grantee) STATE OF VIRGINIA ) )ss. CITY/COUNTY OF __________________ ) The foregoing instrument was acknowledged before me this ________ day of _________________, 2004, by YYY and XXX. _________________________ Notary Public My commission expires: This deed was prepared by: