SCHEDULE A
GF NO.:
Owner Policy No.: O-5841-
Date of Policy:
Amount of Insurance: $100,000.00
1. Name of Insured: Peppermint Patti
2. The estate or interest in the land that is covered by this policy is:
Fee Simple as to Parcel I
Leasehold Estate as to Parcel II
3. Title to the estate or interest in the land is insured as vested in: Peppermint Patti
4. The land referred to in this policy is described as follows:
Parcel I:
LOT 2, BLOCK 1, ROYAL ACRES, a subdivision of land in Peanutsville City, Schultz County, State of Comics, according to the recorded plat thereof.
Parcel II:
The leasehold estate created by the lease executed by Charlie Brown, as lessor, to Peppermint Patti, as lessee, dated October 31, 1992, recorded November 1, 1992, in Book XX, Page YY, demising and leasing for a term of 7 years, beginning October 31, 1992, and ending October 31, 1999, the following described premises, to-wit:
LOT 1, BLOCK 1, ROYAL ACRES, a subdivision of land in Peanutsville City, Schultz County, State of Comics, according to the recorded plat thereof.
OWNER POLICY
SCHEDULE B
EXCEPTIONS FROM COVERAGE
Policy No.: O-5841-
This policy does not insure against loss or damage (and the Company will not pay costs, attorney's fees or expenses) that arise by reason of the terms and conditions of the leases and easements, if any, shown in Schedule A, and the following matters:
1. The following restrictive covenants of record itemized below (The Company must either insert specific recording data or delete this exception.):
2. Any discrepancies, conflicts, or shortages in area or boundary lines, or any encroachments or protrusions, or any overlapping of improvements.
3. Homestead or community property or survivorship rights, if any of any spouse of any insured.
4. Any titles or rights asserted by anyone, including but not limited to, persons, the public, corporations, governments or other entities,
a. to tidelands, or lands comprising the shores or beds of navigable or perennial rivers and streams, lakes, bays, gulfs or oceans, or
b. to lands beyond the line of the harbor or bulkhead lines as established or changed by any government, or
c. to filled-in lands, artificial islands, or
d. to statutory water rights, including riparian rights, or
e. to the area extending from the line of mean low tide to the line of vegetation, or right of access to that area or easement along and across that area.
5. Standby fees, taxes and assessments by any taxing authority for the year 20__, and subsequent years, and subsequent taxes and assessments by any taxing authority for prior years due to change in land usage or ownership.
6 The following matters and all terms of the documents creating or offering evidence of the matters (The Company must insert matters or delete this exception.):
Mortgage dated October 31, 1992, recorded November 1, 1992, in Book XX, Page YY, executed by Peppermint Patti to ABC Corporation stating that it secured the sum of $80,000.00.
____________________________ )
____________________________ ) Exceptions affecting fee simple
____________________________ )
____________________________ )
____________________________ ) Exceptions affecting the leasehold estate
____________________________ )
Leasehold Owner Endorsement attached hereto is incorporated into and made an integral part of Schedule B.
Countersigned:
By ___________________
Authorized Countersignature
No guidelines are available for this form at this time.