Fill and Sign the This Instrument Prepared by and Please Return to Form

- Quitclaim Deed - Page 1 - This instrument prepared by, and please return to:Name Address Rec. $ Property Appraiser’s ParcelDoc.St.$ ID No. QUITCLAIM DEED(Corporation to Husband and Wife) THIS QUITCLAIM DEED, Made the ______ day of __________________, 20___, by ______________________________, a Corporation organized under the laws of the state of ______________________, hereinafter referred to as “Grantor”, to ______________________ and ______________________, Husband and Wife, tenants by the entireties, hereinafter called “Grantees”. Witn ess e th , th at th e G ra n to r, f o r a n d in c o nsid era tio n o f th e s u m o f te n d olla rs ($10.00), and other good and valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged, does hereby remise, release, and quitclaim unto Grantees the following lands and property, together with all improvements located thereon, lying in the County of ______________________, State of Florida, 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, Florida. LESS AND EXCEPT all oil, gas and minerals, on and under the above described property owned by Grantor, if any, which are reserved by Grantor.SUBJECT to restrictions, reservations, easements, and covenants of record, reference hereto will not serve to reimpose the same. - Quitclaim Deed - Page 2 - TO HAVE AND TO HOLD the same together with all and singular the appurtenances thereunto belonging or in anywise appertaining, and all the estate, right, title, interest, lien, equity and claim whatsoever of the said Grantor, either in law or equity, to the only proper use, benefit and behalf of the Grantees forever. Tax es f o r t a x y ear _ _____ s h all b e p ro ra te d b etw een G ra n to r a n d G ra n te es a s o f t h e d ate sele cte d b y G ra n to r a n d G ra n te e, o r p aid b y G ra n te es, o r p aid b y G ra n to r. TO HAVE AND TO HOLD to the said Grantees as tenants by the entireties, their heirs, personal representatives, executors and assigns forever: it being the intention of the parties to this conveyance, that (unless the tenancy hereby created is severed or terminated during the lives of the grantees herein) in the event one Grantee herein survives the other, the entire interest in fee simple shall pass to the surviving Grantee, and if one does not survive the other, then the heirs and assigns of the Grantees herein shall take as tenants in common.IN WITNESS WHEREOF, this deed was executed by the undersigned on this the ____ day of __________________, 20___.Signed, Sealed and Delivered {Name of Corporation}in the presence of these Witnesses(one of whom may be the Notary):Sign: BY: Witness Signature TITLE: Printed Name Sign:____________________________ Printed Name Witness Signature Printed NameSTATE OF _____________________COUNTY OF _______________________ The foregoing instrument was acknowledged before me this ___________________ (date) by ___________________________________________________ (name and title of officer) of _____________________________________, a ___________________ (state) corporation, on behalf of the corporation. He/she is personally known to me or has produced _____________________________________ (type of identification) as identification. ______________________________Notary PublicPrinted Name: ___________________ My Commission Expires: ___________________Commission # ____________ - Quitclaim Deed - Page 3 - Grantor Name, Address, phone: Grantee Name, Address, phone: SEND TAX STATEMENTS TO GRANTEE Exhibit A EXHIBIT A