KNOW ALL MEN BY THESE PRESENTS:

That .............. of the County of........ and State of .......... in consideration of the sum of......dollars, to......paid by........the receipt whereof is hereby acknowledged, do.. hereby GRANT, BARGAIN, SELL AND CONVEY to the said .......... heirs and assigns forever, the following described Real Estate, situate in the County of .......... in the State of

.......... and in the..........and bounded and described as follows, viz.:

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and all the Estate, Title and Interest of the said grantor.......... either in

Law or in Equity, of, in and to the said premises, together with all the privileges and appurtenances to the same belonging, and all the rents, issues and profits thereof; to have and to hold the same to the only proper use of the said grantee ...... heirs and assigns forever, and the said ............ for

...... and for ...... heirs, executors and administrators, do.. hereby covenant with the said grantee.., ....... heirs and assigns, that....... the true and lawful owner.. of the said premises, and ha.. full power to convey the same, that the title, so conveyed, is clear, free and unincumbered; and further, that ......will warrant and defend the same against all claim or claims of all persons whomsoever.

Provided, Nevertheless, that .............................................

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It is agreed between the parties hereto that said mortgagors shall and will keep the building or buildings erected and to be erected upon the premises above described, fully insured against loss by Fire and Tornado, in such Companies and for such amounts as said mortgages and assigns shall approve, and shall cause to be indorsed on such policy or policies of insurance "loss if any, payable to .......... as his mortgage interest may appear" and shall deliver the same to said mortgagee and assigns to be held as collateral security hereto; and in default thereof it shall be lawful for said mortgagee or assigns to effect such insurance, as mortgagee or otherwise, and the premium or premiums paid for effecting and continuing the same shall be a further lien on said mortgaged premises added to the amount of said note secured by these presents, and payable on demand with 8 per cent interest.

Then these presents shall be void; otherwise to be and remain in full force and virtue.

IN WITNESS WHEREOF, the said..........hereby release.......right and expectancy of dower in said premises, ha.. hereunto set ...... hand..

this ......day of ........ in the year of our Lord, one thousand nine hundred and ..........

Signed and acknowledged in presence of us:

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(ACKNOWLEDGMENT)