Fill and Sign the On the Day of in the Year Before Me Form

Prepared by, recording requested by and return to:Name: Company: Address: City: State: Zip: Phone: Fax: ----------------------Above this Line for Official Use Only--------------------- MEMORANDUM AND NOTICE OF OPTION TO PUCHASE THIS notice is entered into and provided by ________________________________________, "Seller(s) and ______________________________________, “Buyer(s)”, on the date stated below.FOR VALUABLE CONSIDERATION, the receipt and sufficiency of which is hereby acknowledged, Buyer(s) grants to Seller(s) an exclusive option to purchase real property owned by Seller(s) and located in ________________ County, _____________________, such real property being more fully described as follows:SEE ATTACHED EXHIBITThe option is for a period of __________ ( ) years commencing on _______________________________ and ending on _____________________________. The option is subject to the terms and conditions of that certain option agreement between Seller(s) and Purchaser(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000.________________________________ Seller_____________________________________ Buyer________________________________ Seller_____________________________________BuyerSTATE OF NEW YORKCOUNTY 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(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. ______________________________Notary PublicPrinted Name: _________________ My Commission Expires: _____________________STATE OF NEW YORKCOUNTY 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(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. ______________________________Notary PublicPrinted Name: _________________ My Commission Expires: _____________________Seller Name and AddressBuyer Name and AddressName:Name:Address:Address:City:City:State: Zip:State: Zip:Phone:Phone:Seller Name and AddressBuyer Name and AddressName:Name:Address:Address: City:City:State: Zip:State: Zip:Phone:Phone: