SHORT FORM OF OPTION TO LEASE REAL ESTATE FOR RECORDING (SITE NAME) For and in consideration of ten dollars ($10.00) cash in hand paid and other good and valuable considerations, the receipt and sufficiency of which is hereby acknowledged, the below named LESSOR hereby grants unto LESSEE for a period of six (6) months from date hereof the exclusive right and option to lease the real property situated in the County of , all as more particularly described as: The rights and obligations herein set forth are subject to the terms and conditions set out in Option to Lease Real Estate (Long Form) related to the above described lands which has been executed by the parties hereto on or before the date hereof, same being incorporated by reference. The LESSEE shall have the option to extend the period for an additional six month period by tendering to LESSOR an additional sum as set out in the long form prior to the end of the first option period. This Short Form is recorded to serve as public notice. Notice to LESSOR of exercise of the Option during the term as provided in said Long Form will convert the option into a contract to lease, all as more fully set forth therein. The lease, when and if executed, would extend upon exercise of all options for a period not to exceed years from the effective date. __________________________________ LESSOR __________________________________ LESSEE STATE OF___________________________ COUNTY OF_________________________ _________________________ Personally appeared before me, the undersigned authority in and for the said State and County, within my jurisdiction, the within named and who acknowledged that they each executed the above and foregoing instrument. WITNESS my hand and seal on this the day of , 20 . NOTARY PUBLIC My Commission Expires: PREPARED BY: ______________ (_________ Bar # ______________) ______________ ______________, _________ ________ Telephone: ______________ Fax: ______________ Witness the hand and seal of the LESSEE and LESSOR on this the day of , 20 .