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Quitclaim Deed Page 1 of 3 QUITCLAIM DEED (Husband and Wife to LLC) KNOW ALL MEN BY THESE PRESENTS THAT: FOR VALUABLE CONSIDERATION OF TEN DOLLARS ($10.00), and other good and
valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged,
______________________________ and ______________________________, Husband and Wife,
hereinafter referred to as “Grantors”, do hereby remise, release, and forever quitclaim, both in law and
equity, unto ______________________________ , a Limited Liability Company organized under the laws
of the state of _______________, hereinafter “Grantee”, the following lands and property, together with
all improvements located thereon, lying in the County of ______________________, State of West
Virginia, to-wit: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description: Prior instrument reference: Book _ _____ , P ag e _ _____ , D ocu m en t N o. _ _____ , o f t h e R eco rd er o f ______________________ County, West Virginia.LESS AND EXCEPT all oil, gas and minerals, on and under the above described property owned
by Grantors, if any, which are reserved by Grantors.SUBJECT to all easements, rights-of-way, protective covenants and mineral reservations of
record, if any. TO HAVE AND TO HOLD same unto Grantee, and unto Grantee’s assigns forever, with all
appurtenances thereunto belonging.CO M PL ETE A LL A PPL IC A BLE S T A TEM EN TS: T he gra n to r(s ) here in does/d o here b y
decla re t h at t h is i s a t r a n sfe r e x em pt f ro m t h e e x cis e t a x ; U nder t h e p en altie s o f f in e a n d i m pris o nm en t a s
pro vid ed b y la w , th e g ra n to r(s ) d oes/d o h ere b y d ecla re (s ) th at th e to ta l c o nsid era tio n fo r th e re al e sta te
tra n sfe rre d b y t h is d ocu m en t i s _ ______ ___________ D olla rs ( $ _ _________________ ).
Quitclaim Deed Page 2 of 3WIT N ESS G ra n to r(s ) h an d(s ) t h is t h e _ ___ d ay o f _ _______________ , 2 0____ .(1st
Grantor’s Signature)(2nd
Grantor’s Signature) Type or Print Name Type or Print NameSTATE OF _________________________COUNTY OF _________________________This instrument was acknowledged before me on _________________________ (date) by
__________________________________________ (name or names of person or persons
acknowledging). ______________________________Notary PublicPrinted Name: ___________________ My Commission Expires: ___________________
DECLARATION OF CONSIDERATION OR VALUE
I hereby declare: (a) The total consideration paid for the property conveyed by the document to which this declaration is
appended is $________________________; or (b) The true and actual value of the property transferred by the document to which this declaration is
appended is, to the best of my knowledge and belief $________________________; or (c) The proportion of all the property included in the document to which this declaration is appended
which is real property located in West Virginia is ____________%; the value of all the property
$________________________; the value of real estate in West Virginia is
$________________________; or
Quitclaim Deed Page 3 of 3 (d) This deed conveys real estate located in more than one county in West Virginia; the total
consideration paid for, or actual cash value of, all the real estate located in West Virginia conveyed by
this document is $________________________; and documentary stamps showing payment of all of the
excise tax on all of said real estate are attached to an executed counterpart of this deed recorded in
__________________ County.Given under my hand this ______ day of __________________ , 20______.Signature Type or Print NameNature of Interest in Conveyance: Grantor Grantee Other Specify: Prepared by and after Recording Return to:Name:___________________Firm/Company: ___________________Address:___________________Address 2:___________________City, State, Zip: ___________________Phone:___________________Preparer’s signature: ______________________________Grantor(s) Name, Address, phone: Grantee(s) Name, Address, phone: SEND TAX STATEMENTS TO GRANTEE
Quitclaim Deed Exhibit A EXHIBIT A
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