1. Rights or claims of parties in possession, not shown of record, and questions of survey.

2. Mechanics' liens, if any, where no notice appears of record.

3. Special assessments not confirmed, or confirmed after _________[date].

4. Building line established in the instrument recorded as Document _________.

5. Restrictions contained in instrument recorded as Document _________.

6. Agreement for party wall, recorded as Document _________.

7. Mortgage encumbrance recorded as Document _________.

8. General taxes for the year _________.

9. Special assessment, warrant No. _________.

10. Special assessment, warrant No. _________.

11. Zoning and building ordinances _________.

12. Acts done or suffered by or judgments against _________.

You are then authorized and directed to disburse money as follows: _________.

Are fire insurance policies to be assigned? _________. Are mortgage clauses to be attached? _________. Amount _________.

Are leases to be assigned? _________.

Have water taxes been paid? _________. Are receipts to be produced? _________.

Objections Nos. _________ erased before signing.

Deliver abstract to _________.

Deliver policies as follows: _________.

Your charges are to be paid as follows: _________.