KNOW ALL MEN BY THESE PRESENTS, That.

the part...of the first part, in consideration of the sum of

...................................................... Dollars, lawful money of the United States of America, to..............

in hand paid by...............................................

the part.. .of the second part, at or before the ensealing and delivery of these presents, the receipt whereof is hereby acknowledged, has.....granted, bargained, sold, assigned, transferred and set over, and by these Presents, do...grant, bargain, sell, assign, transfer and set over unto the said part...of the second part ....................................................heirs, executors, administrators and assigns, a certain Indenture of

Mortgage, bearing date the................................day of..................................................in the year

One Thousand Nine Hundred.................made by........

and all................right, title and interest to the premises therein described, as follows, to-wit: which said Mortgage is recorded in the Recorder's Office of the

County of.........................................in the State of..................................in Book No...............

of..................at page..................

Together with the...................................therein described, and the money due or to grow due thereon with the interest, To have and to hold the same unto the said part...

of the second part,..................................executors, administrators, or assigns, forever :............................

subject only to the provisos in the said Indenture of Mortgage contained:

And...............do, for.............................heirs, executors, administrators, covenant with the said part...of the

2IO second part,...................................heirs, executors, administrators and assigns, that there is now actually.........

...............................owing on said.................

and Mortgage, in principal and interest,........................

Dollars, and that................have good right to assign the same:

And.................do hereby make, constitute and appoint the said part.. .of the second part..............true and lawful

Attorney, irrevocably, in................name..., or otherwise, but at..................own proper costs and charges, to have, use, and take all lawful ways and means for the recovery of the said money and interest, and, in case of payment, to discharge the same as fully as.............................might, or could do, if these Presents were not made.

In Witness Whereof......................have hereunto set

......................hand...and seal..., this................

day of.............................in the year One Thousand

Nine Hundred........................................

Sealed and Delivered in Presence of }

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

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

(Acknowledged, see form 3.)