Fill and Sign the Due Execution of the Foregoing Instrument 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 Seller(s) and located in ________________ County, _____________________, such real property being more fully described as follows:SEE ATTACHED EXHIBITThe 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 between Seller(s) and Purchaser(s) dated the ______ day of ________________, _________. IN WITNESS WHEREOF, on this the ______ day of ____________, 2000.________________________________ Seller_____________________________________ Buyer________________________________ Seller_____________________________________BuyerSTATE OF NORTH CAROLINACOUNTY OF _____________________ I, a Notary Public, do hereby certify that _________________________________ (here give the name of the grantor or maker) personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and (where an official seal is required by law) official sealThis the ___________________ day of ___________________ (year). (Official seal.) ______________________________Notary Public Printed Name: _________________ My Commission Expires: _____________________STATE OF NORTH CAROLINACOUNTY OF _____________________ I, a Notary Public, do hereby certify that _________________________________ (here give the name of the grantor or maker) personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and (where an official seal is required by law) official sealThis the ___________________ day of ___________________ (year). (Official seal.) ______________________________Notary Public Printed Name: _________________ My Commission Expires: _____________________Seller Name and AddressBuyer Name and AddressName:Name:Address:Address:City:City:State: Zip:State: Zip:Phone:Phone:Seller Name and AddressBuyer Name and AddressName:Name:Address:Address: City:City:State: Zip:State: Zip:Phone:Phone: