Fill and Sign the Procedures for Withdrawing Rental Units from the Hcidla 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 LEASE AGREEMENT THIS notice is entered into and provided by ________________________________________, "Lessor(s) and ______________________________________, “Lessee(s)”, on the date stated below.FOR VALUABLE CONSIDERATION, the receipt and sufficiency of which is hereby acknowledged, Lessor(s) lease to Lessee(s) certain real property owned by Lesor(s) and located in ________________ County, _____________________, such real property being more fully described as follows:SEE ATTACHED EXHIBITThe lease is for a period of __________ ( ) years commencing on _______________________________ and ending on _____________________________. The lease is subject to the terms and conditions of that certain lease agreement between Lessor(s) and Lessee(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000.________________________________ Lessor_____________________________________ Lessee________________________________ Lessor_____________________________________LesseeSTATE OF ARKANSASCOUNTY 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 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 PublicPrinted Name:_________________My Commission Expires: ___________________STATE OF ARKANSASCOUNTY 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 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 PublicPrinted Name:_________________My Commission Expires: ___________________Lessor Name and AddressLessee Name and AddressName:Name:Address:Address:City:City:State: Zip:State: Zip:Phone:Phone:Lessor Name and AddressLessee Name and AddressName:Name: Address:Address:City:City:State: Zip:State: Zip:Phone:Phone: