Quitclaim Deed Page 1 of 3
QUITCLAIM DEED
(Individual to Individual)
KNOW ALL MEN BY THESE PRESENTS THAT: FOR VALUABLE CONSIDERATION OF TEN DOLLARS ($10.00), and other good and
valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged,
______________________________ , an Individual,
married unmarried, hereinafter referred to as
“Grantor”, does remise, release, and forever quitclaim, both in law and equity, unto
______________________________ , an Individual, married unmarried, hereinafter “Grantee”, the
following lands and property, together with all improvements located thereon, lying in the C ounty of
______________________, State of West Virginia, to-wit:
See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full
Legal Description:
Prior instrument reference: Book ______, Page ______, Document No. ______, of the Recorder of
______________________ County, West Virginia.
LESS AND EXCEPT all oil, gas and minerals, on and under the above described property owned
by Grantor, if any, which are reserved by Grantor.
SUBJECT to all easements, rights-of-way, protective covenants and mineral reservations of
record, if any.
TO HAVE AND TO HOLD same unto Grantee, and unto Grantee’s heirs and assigns forever,
with all appurtenances thereunto belonging.
COMPLETE ALL APPLICABLE STATEMENTS: The grantor(s) herein does/ do hereby
declare that this is a transfer exempt from the excise tax; Under the penalties of fine and imprisonment as
provided by law, the grantor(s) does/do hereby declare(s) that the total consideration for the real estate
transferred by this document is __________________ Dollars ($ __________________).
Quitclaim Deed Page 2 of 3
WITNESS Grantor(s) hand(s) this the ____ day of ________________, 20____.
(1st
Grantor’s Signature)
Print Name
STATE OF _________________________
COUNTY OF _________________________ This instrument was acknowledged before me on _________________________ (date) by
__________________________________________ (name or names of person or persons
acknowledging).
______________________________
Notary Public
Printed 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
(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
Quitclaim Deed Page 3 of 3
excise tax on all of said real estate are attached to an executed counterpart of this deed recorded i n
__________________ County.
Given under my hand this ______ day of __________________, 20______.
Signature
Type or Print Name
Nature 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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