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Lady Bird Deed

This Deed is made on this day of _______________, 20__, between the

Grantor ______________________________

of address __________________________________________________ and the

Grantee Beneficiary ______________________________

of address _________________________________________________.

For good and valuable consideration paid by the Grantee Beneficiary, the receipt of which is hereby acknowledged, the Grantor does transfer and convey the following described property to the Grantee Beneficiary effective on the Grantor's death:

Property Address: ______________________________________________________________

Legal Description: ______________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

The Grantor reserves a life estate for himself/herself during the Grantor's lifetime coupled with an unrestricted power to convey during the Grantor's lifetime, which includes the power to sell, gift, mortgage, lease and otherwise dispose of the property, and to retain the proceeds from the conveyance.

EXECUTED this day of _______________, 20__.

Grantor Name: _________________________

Grantor Signature: ______________________

STATE OF _________________________

COUNTY OF _________________________

On this day, personally appeared before me, _________________________, to me known to be the

person(s) described in and who executed the within instrument, and acknowledged that he/she signed the same as his/her voluntary act and deed, for the uses and purposes therein mentioned.

Witness my hand and official seal hereto affixed on this day of _______________, 20__.

Notary's Public Signature: ______________________