Fill and Sign the Pennsylvania Option 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 PENNSYLVANIA COUNTY OF ______________ On this, the ____________ day of __________________, ____________, before me ________________________________________, the undersigned officer, personally appeared _____________________________________, known to me (or satisfactorily proven) to be the person whose name ______________________ 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 Printed Name: _________________ My Commission Expires: _____________________ STATE OF PENNSYLVANIA COUNTY OF ______________ On this, the ____________ day of __________________, ____________, before me ________________________________________, the undersigned officer, personally appeared _____________________________________, known to me (or satisfactorily proven) to be the person whose name ______________________ 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 Printed Name: _________________ My 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: