Fill and Sign the Life Estate 497303680 Form

After Recording Return to: ) ) ) ) ) ) ) ) -Above This Line Reserved For Official Use Onli- STATE OF GEORGIA COUNTY OF _________________ EXECUTOR'S DEED THIS INDENTURE , made this the ____ day of _______________, 20____, between ___________________________ (Name of Executor) of ______________________________ ___________________________ (street address, city, state, zip code), as Executor of the Last Will and Testament of _____________________________ (Name of Testator or Testatrix), late of the State of Georgia, and County of ___________________________ (Name of County), deceased, hereinafter called the Grantor, and ______________________________ (Name of Grantee) of __________________________________________________________________ (street address, city, state, zip code), hereinafter called Grantee One, ___________________ ______________ (Name of Grantee) of ____________________________________________ ____________________ (street address, city, state, zip code), hereinafter called Grantee Two, and ______________________ (Name of Grantee) of _________________________________ __________________________________ (street address, city, state, zip code), hereinafter called Grantee Three. WITNESSETH : that for and in consideration of the sum of TEN AND 00/100's ($10.00) Dollars and other valuable considerations in hand paid at and before the sealing and delivery of these presents, the receipt whereof being hereby acknowledged, the said Grantor (acting under and by virtue of the power and authority contained in the said Will, the same having been duly probated and recorded in the Superior Court of ______________________ (Name of County), Georgia, Estate No. ____________), has granted, bargained, sold and conveyed, and by these 1 presents does grant, bargain, sell and convey unto the said Grantees the property described in Exhibit A (the Property ) attached hereto and made a part hereof. TO HAVE AND TO HOLD the said tract or parcel of land and Property , with all and singular the rights, members and appurtenances thereto, to the being, belonging, or in anywise appertaining, to the only proper use, and benefit and of the said Grantees forever, but with the title to and interest in said Grantees to be limited and described as follows: To Grantee One, title to and all rights in the Property during the lifetime of Grantee One (e.g., a life estate) subject to divestment upon and on the following events (the Events ): a. the abandonment by Grantee One of the said Property as her homestead for a period of six months or longer; b. the failure of Grantee One to pay any taxes on any portion of the Property; c. the failure of Grantee One to maintain hazard insurance on the House on the Property with said insurance to at least equal to the fair market value of said House ; and/or d. the failure of Grantee One to maintain the House on the Property in a habitable condition; Upon the occurrence of any of the Events described above, title to and all rights in the Property shall pass to Grantee One, Grantee Two and Grantee Three as tenants in common. Upon the death of Grantee One prior to any of the aforesaid Events, title to and all rights in the Property shall pass to Grantee Two , Grantee Three , and the heirs at law of Grantee One , per stirpes ( i. e., by right of representation, share and share alike) , with said Grantees to hold title to the Property as tenants in common. IN WITNESS WHEREOF, Grantor has hereunto set his/her hand and seal, the day and year first above written. Witness the signature of Grantor this the ____ day of _________________, 20_____. 2 _______________________________ (Signature of Executor) _______________________________ (Printed Name of Executor) Executor of the Last Will and Testament of ______________________ (Name of Testator/Testatrix) This Deed was signed, sealed and delivered in the presence of: ___________________________________ (Signature of Witness) ___________________________________ (Printed Name of Witness) State of Georgia ss. County of _________________ (Name of County) I, _________________________ (Name of Notary Public) , a Notary Public residing in the county and state named above, do certify that _______________________ (Name of Executor), as Executor of the Last Will and Testament of _______________________________ (Name of Testator/Testatrix) and ____________________________ (Name of Witness), who are personally to me known, this day appeared before me personally and acknowledged that they signed, sealed, and delivered the foregoing Executor’s Deed as set forth above, of their own free will and accord, for the purposes therein named and expressed. In witness whereof, I have hereunto set my hand and official seal, this _______ day of ________________________, 20_____. ________________________________ (Signature of Notary Public) ________________________________ (Printed Name of Notary Public) Notary Public My Commission Expires on ___________________ (date). ( Seal ) 3 4