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-a,i <br />By: <br />(Signature) <br />Individual Selling Agent/license #: n/a <br />Firm Name: Exit Realty Southpoint <br />Acting as Buyer's Agent Seller's (sub)Agent Dual Agent <br />Individual Listing Agent/license #: 214 s s s <br />Firm Name: Exit Realty Southpoint <br />Acting as Seller's (sub)Agent Dual Agent <br />This form jointly approved by: North Carolina Bar Association, North Carolina Association of REALTORS®, Inc. <br />PREPARED BY: stepney edwards, broker <br />3TANOARD FORM 12-T Revised 1/2008 ©1/2008 <br />~eaIFA$T®Software, ©20e~08/,Version 6.17 Beia. Software Registered to: Office Manager, Exit Realty Southpoint <br />iuyer' initials !!rL~ _ 05/21/08 14:24:04 <br />Seller initials~~~ ~ age 7~f~7 <br />