SURVIVORSHIP DEED Know all Men by these Presents That, __________________________________________________ marital status_________________ of Cuyahoga County, Ohio for valuable consideration paid, Grants, (Covenants, if any), to _________________________________________________________________ for their joint lives, remainder to the survivor of them, whose tax mailing address is: ___________________________________________________________________________________ The following described Real Property: See Exhibit "A" attached. Permanent Parcel No. _______________________________________________ Prior Instrument Reference: AFN# _________________________________________ of Cuyahoga County Records To have and to hold the above granted and bargained premises, with the appurtenances thereof, unto the said Grantee, their heirs and assigns forever, And for valuable consideration I,__________________________________________ do hereby remise, release and forever quit-claim unto the said Grantee, his heirs and assigns, all my right and expectancy of Dower in the above described premises. Executed this _______ Day of __________________________________, 20 _______ ________________________________________ Grantor ________________________________________ Grantor State of Ohio, County of Cuyahoga Before me, a Notary Public in and for said County and State, personally appeared the above named List Grantor(s):_________________________________________________________________________ Who acknowledge that they did sign the foregoing instrument and that the same is their free act and deed. In Testimony Whereof, I have hereunto set my hand and official Seal, at ___________________________, __________________ This ________ Day of ______________________, A.D. 20____ Prepared By: ______________________________________ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com