Property & Mineral Rights Questionnaire

Please provide detailed information about your property and mineral rights

Account Number

Name

Parish

Approximate Acreage

Legal Description

Parcel Numbers

Owner Names & Ownership Percentages

How Was Interest Acquired

If Other, Please Describe

Date of Acquisition

Do You Have Any Title Issues?

Title Issues Description

Are There Any Liens or Encumbrances?

Liens Description

Do You Own Mineral Rights?

Partial Minerals Explanation

Have Minerals Been Severed or Sold?

Mineral Severance Details

Are Minerals Currently Under Lease?

Lessee or Operator Name

Lease Expiration Date

Is There a Production History?

Production Details

Current Surface Use

If Other Surface Use, Please Describe

Are There Surface Leases or Agreements?

Surface Leases Details

Are There Easements or Rights of Way?

Easements Details

Are There Environmental or Surface Issues?

Environmental Issues Details

Would You Like to Know Your Mineral Value?

Additional Details

Signature Name

Signature Date

Contact Email

Contact Phone