THIS INDENTURE WITNESSETH, that the Grantor............

of the.............................in the County of...................

and State of.................for the consideration of..................

........................................................ DOLLARS,

Convey. .. .and Quit-Claim. .. .to ...................................

of the ......................County of....................and State of................all interest in the following described Real Estate, to-wit:

..................................................................................................................................

...............................................................................................................................

situated in the County of..................in the State of Illinois, hereby releasing and waiving all rights under and by virtue of the Homestead Exemption Laws of this State of...........................

Dated, this....................day of...............A. D. 190..

...........................(Seal.)

...........................(Seal.)

...........................(Seal.)

...........................(Seal.)

State OF ...............

County of .............

ss.

I,....................................

.........in and for said County, in the

State aforesaid, DO HEREBY CERTIFY That........

personally known to me to be the same person, .whose name...............subscribed to the foregoing instrument, appeared before me this day in person, and acknowledged that .... he.... signed, sealed and delivered the said Instrument as .......... free and voluntary act, for the uses and purposes therein set forth, including the release and waiver of the right of homestead.

Given Under my hand and..............Seal, this..............day of.................A. D. 190..