<p> BEILER-CAMPBELL REALTORS – ESCROW RECORD AUCTION DEPT. DATE RECEIVED FROM / PAID TO DEP.# CHECK# RECV’D OP. CL. CK. BALANCE MLS#: N/A Referral: No INT. INT. AMOUNT BUYER: SELLER: Blain Fire Company(Consignment PROPERTY ADDRESS: Auction) AGREEMENT DATE: PROPERTY ADDRESS: Blain Picnic Grounds Blain, Pa. SETTLEMENT DATE: SALE PRICE: COMM AMT: SOURCE OF BUSINESS: LIST: 8 DEPOSIT: Interest Bearing: NO SALE: ADD’L DEPOSIT: DATE DUE: List Side $______Sale Side $______CHECK ONE: List Side $______Sale Side $______CK#_____ □ 10 Lots/Land □ 40 New Construction List Side $______Sale Side $______50 % Paid to: ______CK#______□20 Industrial/Farms □50 Commercial</p><p>□ 0 Residential ●Personal Property COMMISSION DISBURSEMENT: Settlement Date: ______Total Comm Rec’d: $______Referral Paid Out/Other Company: NET COMMISSION: Conveyancing Fee Received: $______</p><p>SALESPERSON LEV % VALUE AMOUNT CHECK # List Commission J. Meryl Stoltzfus To: Less Deductions Net Amount Paid Co-List Commission To: Less Deductions Net Amount Paid Sales ------Commission To: Less ______Deductions Net Amount Paid Co-Sales ______Commission: Less Deductions Net Amount Paid BALANCE TO COMPANY: DATES CHECKS WRITTEN:______BY:______</p>