Fill and Sign the On This 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 Selle r(s) and located in ________________ County, _____________________, such real property being more fully described as follows: SEE ATTACHED EXHIBIT The 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 be tween Seller(s) and Purchaser(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000. ________________________________ Seller _____________________________________ Buyer ________________________________ Seller _____________________________________ Buyer STATE OF NORTH DAKOTA COUNTY OF _____________________ On this ________ day of __________________ , in the year __________, before me personally appeared _________________________, known to me (or proved to me on the oath of ___________________________) to be the person who is described in and who executed the within and foregoing instrument, and acknowledged to me that ________________________________________________ (he/she/they) executed the same. (Seal) ______________________________ Notary Public Printed Name: _________________ Commission Expires: _________________ STATE OF NORTH DAKOTA COUNTY OF _____________________ On this ________ day of __________________ , in the year __________, before me personally appeared _________________________, known to me (or proved to me on the oath of ___________________________) to be the person who is described in and who executed the within and foregoing instrument, and acknowledged to me that ________________________________________________ (he/she/they) executed the same. (Seal) ______________________________ Notary Public Printed Name: _________________ Commission Expires: _________________ Seller Name and Address Buyer Name and Address Name: Name: Address: Address: City: City: State: Zip: State: Zip: Phone: Phone: Seller Name and Address Buyer Name and Address Name: Name: Address: Address: City: City: State: Zip: State: Zip: Phone: Phone: