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FORM 49.

Extension, Modification, Termination, or Assignment of Simple Contract

THIS (add, such as Extension, Modification, Termination, or Assignment)


of Contract, is made by and between (Name of Individual or business "Party #1,"
located at: ___) and (Name of Individual or business "Party #2," located at: ___)
on (specify date).

WHEREAS, the parties desire to: (specify)

NOW, THEREFORE, FOR VALUABLE CONSIDERATION SET FORTH HEREIN, THE


PARTIES AGREE AS FOLLOWS:

1. The prior Agreement dated (specify) is hereby (extended, modified,


terminated, or assigned) as follows: (specify).
2. a. If extended, state whether all other terms and conditions are
the same as the original contract or are changed.
b. If modified, state which terms are changed, then state that
all other terms and conditions remain in effect without modification.
c. If terminated, state when.
d. If assigned, state to whom and that the Assignee agrees to
perform all of the duties and obligations of the Assignor.
3. Set forth other pertinent conditions, such as term of the contract
and whether it can be extended after the initial term.
4. This Agreement supersedes all prior agreements and understandings
and may only be modified in writing and signed by both parties. This Agreement is
in force when signed below.
5. This Agreement binds and benefits both parties and any successors
and assigns.
6. This Agreement shall be governed by the law of the state of
(specify).

____________________________

Name of Party #1
Dated: _________________

____________________________

Name of Party #2