(Illinois.)

THIS INDENTURE WITNESSETH, That the Mortgagor of the........................in the County of............and

State of.........................Mortgage.. .and Warrant.. .to of the County of..................................and State of

....................to secure the payment of............certain promissory note..., executed by...............................

bearing even date herewith, payable to the order of.............

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.

Dated, This..............day of.................A. D. 19....

..............................(seal)

.............................. (seal)

..............................(seal)

..............................(seal)

(Acknowledged; see form 3.)