Fill and Sign the On This Day of in the Year Before Me the 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 MISSOURICOUNTY OF ______________ On this ______________ day of _____________________ in the year _________, before me, the undersigned notary public, personally appeared _________________________________, known to me to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. ______________________________Notary Public Print Name: ___________________ My commission expires:___________________STATE OF MISSOURICOUNTY OF ______________On this ______________ day of _____________________ in the year _________, before me, the undersigned notary public, personally appeared _________________________________, known to me to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. ______________________________Notary Public Print 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: