Fill and Sign the Indiana Organization Form

Grantee (name, address and telephone) :                         QUITCLAIM DEED [Non-Profit Organization to an Individual] THIS INDENTURE WITNESSETH , That       , a non-profit organization formed pursuant to the laws of the State of       . RELEASE AND QUITCLAIM To       , of       County, in the State of       , for the sum of       Dollars, the following described REAL ESTATE in       County, in the State of Indiana, to-wit: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description:       Prior Instrument Reference: Instrument No. (10 Digit):       / Book       Page       Quitclaim Deed Page 1 of 3 IN WITNESS WHEREOF, the said       has caused this QUITCLAIM DEED to be executed this ______ day of ____________ , 20 ______ .       NAME OF NON-PROFIT ORGANIZATION By: Signature and Title       Type or Print Name STATE OF INDIANA ,       County, ss: Before me, the undersigned, a Notary Public in and for said County and State, personally appeared the within named       , who acknowledged the execution of the foregoing QUITCLAIM DEED for and on behalf of said ________________________ , a NON-PROFIT ORGANIZATON, and who, being duly sworn, stated that the representations therein contained are true. Witness my hand and       Seal this       day of       , 20       . Notary Public. Resident of       County. My Commission expires       , 20       Quitclaim Deed Page 2 of 3 This Instrument was prepared by:                   Telephone:       Signature       Print or Type Name After Recording, return to:                   Telephone:       Affirmation Statement I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by law. Signature       Print or Type Name Quitclaim Deed Page 3 of 3 EXHIBIT A       Exhibit A