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SCHEDULE 3

This Indenture, made __________ [month, day, year], under the Land Transfer Form Act, Part 2, between [here insert the names of parties and recitals, if any], witnesses that, [lessor] does demise to [lessee], his executors, administrators and assigns, all, etc., [parcels], from __________ [month, day, year], for the term of __________, yielding during the term the rent of [state the rent and mode of payment, also the covenants to be inserted].

In witness of which the parties have set their hands.