IN CONSIDERATION OF THE MUTUAL COVENANTS HEREIN, the following parties, _____________________________________ (hereinafter referred to as Landlord) and ___________________________________ (hereinafter referred to as Tenant) to the Lease Agreement made for premises known as ___________________________________ and dated on ____________________ (Month & Day), _________ (Year) hereby agree to modify and amend said Lease in the following particulars:

(Describe) _______________________________________________________________

________________________________________________________________________

________________________________________________________________________

All other terms and covenants of the original Lease Agreement shall remain as contained.

Signed under seal on this ____________________ (Month & Day), _________ (Year).