Fill and Sign the Private Agreement Form

PRIVATE ANNUITY AGREEMENT Private Annuity Agreement (“Agreement”) made and entered into on this the ____ day of __________, 20____ by and between ____________, a resident of __________ County, State of __________ (hereinafter sometimes referred to as “Transferor”); and ___________, a resident of __________ County, State of ____________ (hereinafter sometimes referred to as “Transferee”). W I T N E S S E T H T H A T: WHEREAS, Transferor is the owner of certain property enumerated on Schedule “A”, such Schedule “A” being attached hereto and incorporated herein by this reference as if set out in full (hereinafter sometimes referred to as the “Property”); and WHEREAS, Transferor desires to transfer the Property at its fair market value to Transferee on the terms and conditions set forth herein in order to provide Transferor with a fixed annual income for the remainder of Transferor’s life, regardless of whether or not the Property produces income and regardless of the level of income produced by the Property, as well as to relieve Transferor from any further obligation and liability with respect to the Property; and WHEREAS, Transferee desires to acquire the Property for its fair market value and is willing to make fixed annual payments for the remainder of Transferor’s life in exchange for the Property, notwithstanding the absence or amount of income from the Property. NOW, THEREFORE, IN CONSIDERATION OF THESE PREMISES AND THE MUTUAL COVENANTS HEREIN CONTAINED, it is hereby agreed between the parties as follows: SECTION 1. CONVEYANCE In consideration of Transferee’s promise to make the payments set forth herein Transferor hereby conveys to Transferee all of Transferor’s right, title, and interest in and to the Property contemporaneous with the execution of this Agreement. Transferor agrees to execute all documents necessary to transfer full and complete title to the Property to Transferee free and clear of all encumbrances. SECTION 2. PAYMENTS In connection of the conveyance by Transferor to Transferee of the Property as set forth herein, Transferee hereby promises to pay to Transferor the annual sum of $______ each year for Transferor’s lifetime, payable on or before the ___________ day of each ________ with the first payment to be made on or before ___________, 20__. While such payments shall be made directly to Transferor, in the event of the disability or other incapacity of Transferor, Transferee may make such payments on behalf of Transferor to any person authorized to receive such payments on behalf of Transferor, including Transferor’s conservator or Transferor’s agent under any durable power of attorney. Transferee’s obligation to make such payments shall cease and terminate with the death of Transferor, irrespective of the number of payments made, but nothing herein shall be construed as avoiding the obligation on the part of Transferee to make any payment due and owing to Transferor but unpaid as of the date of the Transferor’s death to the personal representative of Transferor’s probate estate. This obligation to make such payments shall not terminate because of the death of Transferee prior to the death of Transferor.SECTION 3. IRRESPECTIVE OF PROPERTY OR INCOME The payments to be made by Transferee to Transferor hereunder shall be made within reference to the Property and shall be made irrespective of any income earned by the Property. Such payments shall be the obligation of Transferee and are not limited in any way to the value of the Property. This obligation to make such payments shall continue even if Transferee should sell, assign, pledge, or dispose of in any other manner the Property before the death of Transferor. SECTION 4. NO SECURITY It is understood and agreed by the parties hereto that the obligation of Transferee to make the payments described herein to Transferor is not secured by the Property or by any other Property. Transferor retains no security interest, lien, or pledge with respect to the Property. SECTION 5. RIGHT TO SELL Transferee shall have the right at any time to sell, transfer, assign, or pledge all or any part of the Property, free and clear of any claims whatsoever by Transferor. SECTION 6. BINDING EFFECT This Agreement shall inure to the benefit of and shall be binding upon Transferee and Transferee’s heirs, distributees, and legal and personal representatives. This Agreement shall be binding upon Transferor and Transferor’s heirs, distributees, and legal and personal representatives. No heir, creditor, or distributee of Transferor’s estate, nor Transferor’s estate itself, shall have any rights in this Agreement. This Agreement shall not be assignable by either party, nor shall Transferor’s interest herein be anticipated, hypothecated, or sold. SECTION 7. LAWS OF THE STATE OF _________________ This Agreement shall be construed and enforced in accordance with the laws of the State of ___________________. SECTION 8. ENTIRE AGREEMENT This Agreement contains the entire agreement of the parties, and supersedes any prior written or oral agreements between them pertaining to the subject matter discussed herein. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals on the day and date first above written. __________ __________ STATE OF _______________ ______________ COUNTY I, the undersigned authority, a notary public, do hereby certify that ________________, whose name is signed to the foregoing instrument and who is known to me, acknowledged before me on this day that, being informed of the contents of the foregoing instrument, he/she executed the same voluntarily on the day the same bears date. Given under my hand and official seal on this the ______ day of ______________, 20___. ___________ Notary Public My Commission Expires: ___________ STATE OF _______________ ______________ COUNTY I, the undersigned authority, a notary public, do hereby certify that ________________, whose name is signed to the foregoing instrument and who is known to me, acknowledged before me on this day that, being informed of the contents of the foregoing instrument, he/she executed the same voluntarily on the day the same bears date. Given under my hand and official seal on this the ______ day of __________________, 20___. ___________ Notary Public My Commission Expires: ___________