Real Estate Owners Document

REAL ESTATE OWNERS DOCUMENT

This Real Estate Owners Document (the "Document") is made and delivered as of by the undersigned Owner and delivered to the Recipient identified below. The Owner hereby certifies the representations, disclosures and agreements set forth in this Document.

Owner Identification

Individual Corporation Limited Liability Company (LLC) Trust Other

Property Identification

Parcel / APN:    Year Built:

Ownership Representations and Certifications

The Owner hereby certifies, represents and warrants to Recipient that, as of the Effective Date:

1. Ownership: Owner is the lawful owner of fee simple title to the Property and has full power and authority to execute and deliver this Document and to perform its obligations hereunder. Owner further certifies title is vested in the name set forth above and is not held in nominee name except as disclosed in the attached documents.

2. Liens and Encumbrances: Except as disclosed below or in attachments, there are no mortgages, deeds of trust, mechanic's liens, judgments, or other liens affecting the Property that remain unsatisfied. If any encumbrances exist, list material encumbrances below.

3. Taxes and Assessments: All real property taxes, assessments, utilities and required governmental charges have been paid when due except as set forth below. If taxes are delinquent or escrowed, provide details.

Tenancies, Occupancy and Leases

Owner certifies that the following describes all current leases, tenancies, occupancy agreements, and rent rolls affecting the Property. If none, indicate "None".

Environmental and Health Disclosures

Owner certifies the following statements by checking the appropriate box for each item. If uncertain, select the disclosure and provide explanation in the comment field.

Lead-Based Paint Present? Yes No

Mold or Water Intrusion History? Yes No

Underground Storage Tanks or Suspected Contamination? Yes No

Attachments and Recorded Instruments

Check items attached to this Document and incorporated by reference.

Recorded Deed Recent Title Report Survey / Plot Plan Lease Documents / Rent Roll

Indemnity, Remedies and Survival

Owner agrees to indemnify, defend and hold harmless Recipient from and against any loss, claim, liability or expense (including attorneys' fees) arising from any material inaccuracy in Owner's representations, undisclosed encumbrances, or failure to disclose environmental conditions. The representations and warranties of Owner shall survive the execution and delivery of this Document and any transfer of the Property for a period of two years, except where a longer survival period is required by applicable law.

Governing Law and Entire Agreement

This Document shall be governed by and construed in accordance with the laws of the state identified below without regard to choice of law principles. This Document constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral.

Governing State:

Notices

Notices under this Document shall be delivered to the addresses set forth below by certified mail, personal delivery, or overnight courier and shall be effective upon receipt.

Owner Certification

The undersigned Owner certifies, under penalty of perjury, that the information contained in this Document and in any attached exhibits is true, correct and complete to the best of Owner's knowledge and belief as of the Effective Date. Owner acknowledges that Recipient may rely upon these statements and that false statements may give rise to remedies under law and equity.

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