BLANK TITLE INSURANCE COMPANY

RECORDED DOCUMENT CERTIFICATE

Certificate Number _______________________

TOTAL LIABILITY HEREWITH IS LIMITED TO $25,000.00.

Based on a search of the LAND RECORDS for the DESIGNATED DOCUMENTS set forth in paragraph 3 of the Application executed by the Applicant on the ______ day of _______________ 19____ which Application, or a copy thereof, is attached hereto and made a part hereof, the undersigned BLANK TITLE INSURANCE COMPANY, the COMPANY, hereby certifies to ______________________, the Applicant, that the following identified and attached documents constitute all of the DESIGNATED DOCUMENTS requested in the Application.

DESIGNATED DOCUMENTS:

1. __________________________________________________

2. __________________________________________________

3. __________________________________________________

4. __________________________________________________

This certification provided by this CERTIFICATE is not valid and the COMPANY shall have no liability hereunder unless there is attached hereto the Application, or a copy thereof, executed the _____ day of __________ 19 ___

This CERTIFICATE executed this _____ day of __________ 19 ___

BLANK TITLE INSURANCE COMPANY OR AGENT

By: ___________________________________________

TIRSA RecDocCert (8/1/93)