For value received, ____________(1)_______________, of ____________(2)_______________, assignor, assigns to ___________(3)____________, of _____________(4)____________, assignee, all rights and interest of assignor in an agreement,

dated ______(5)_________, 19__(6)_, whereby assignor was given the option to purchase from _______(7)___________, of ________(8)______________, the following described real estate at

a price and under the terms and conditions therein contained:

[legal description]

Such option commenced on _______(9)______________, 19__(10)_, and is good until __(11)___ o'clock, _(12)_.m., ________(13)___________, 19__(14)_.

Assignor, by virtue of this assignment, grants to assignee the right to exercise or reject the option in good faith and the right to recover any moneys deposited by assignor to receive said option.

Dated ___________(15)____________, 19_(16)__.

____________(17)_______________

STATE OF _______(18)____________ 

COUNTY OF ______(19)____________ 

BEFORE ME, the undersigned authority, on this _(20)_ day of _______(21)________, 19_(22)_, personally appeared ___________(23)___________ to me well known to be the person described in and who signed the Foregoing, and acknowledged to me that he executed the same freely and voluntarily for the uses and purposes therein expressed.

WITNESS my hand and official seal the date aforesaid.

__________(24)_________________

NOTARY PUBLIC

My Commission Expires:__(25)___