Fill and Sign the Control Number Pa 022 77 Form

© 2016 - U.S. Legal Forms, Inc. PENNSYLVANIA QUITCLAIM MINERAL DEED [Four Individuals to One Individual] Control Number: PA-022-77 I. TIPS ON COMPLETING THE FORMS The form(s) in this packet may contain “form fields” created using Microsoft Word or Adobe Acrobat (“.pdf” format). “Form fields” facilitate completion of the forms using your computer. They do not limit your ability to print the form “in blank” and complete with a typewriter or by hand. It is also helpful to be able to see the location of the form fields. Go to the View menu, click on Toolbars, and then select Forms. This will open the Forms toolbar. Look for the button on the Forms toolbar that resembles a shaded letter “a”. Click this button and the form fields will be visible. By clicking on the appropriate form field, you will be able to enter the needed information. In some instances, the form field and the line will disappear after information is entered. In other cases, it will not. The form was created to function in this manner. II. DISCLAIMER These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the state of Pennsylvania. All information and Forms are subject to this Disclaimer: All forms in this package are provided without any warranty, express or implied, as to their legal effect and completeness. Please use at your own risk. If you have a serious legal problem, we suggest that you consult an attorney in your state. U.S. Legal Forms, Inc. does not provide legal advice. The products offered by U.S. Legal Forms (USLF ) are not a substitute for the advice of an attorney. THESE MATERIALS ARE PROVIDED “AS IS” WITHOUT ANY EXPRESS OR IMPLIED WARRANTY OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF INTELLECTUAL PROPERTY, OR FITNESS FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL U.S. LEGAL FORMS, INC. OR ITS AGENTS OR OFFICERS BE LIABLE FOR ANY DAMAGES WHATSOEVER (INCLUDING WITHOUT LIMITATION DAMAGES FOR LOSS OR PROFITS, BUSINESS INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE T HE MATERIALS, EVEN IF U.S. LEGAL FORMS, INC. HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Quitclaim Mineral Deed Page 1 of 4 Prepared by: __________________ Return to: Parcel # QUITCLAIM MINERAL DEED [Four Individuals to One Individual] KNOW ALL MEN BY THESE PRESENTS THAT: FOR VALUABLE CONSIDERATION OF TEN DOLLARS ($10.00), and other good and valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged, ______________________________, an Individual, whose address is ____________________________________, ______________________________, an Individual, whose address is ____________________________________, ______________________________, an Individual, whose address is ____________________________________, and ______________________________, an Individual, whose address is ____________________________________, hereinafter referred to as “Grantors”, do hereby release and quitclaim unto ______________________________, hereinafter “Grantee”, all of Grantor’s mineral interest, including but not limited to coal, oil, gas, carbon dioxide, and all other minerals in, on and under that certain property lying in the County of ______________________, State of Pennsylvania, to- wit: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description: Prior instrument reference: Book ______, Page ______, Document No. ______, of the Recorder of ______________________ County, Pennsylvania. Address of property: ______________________ Quitclaim Mineral Deed Page 2 of 4 SUBJECT to all easements, rights-of-way, protective covenants and mineral reservations of record, if any. IN WITNESS WHEREOF, the Grantors have signed and sealed this Deed, the day and year below written. (1 st Grantor’s Signature) (2 nd Grantor’s Signature) Type or Print Name Type or Print Name (3rd Grantor’s Signature) (4 th Grantor’s Signature) Type or Print Name Type or Print Name State of __________________, County of __________________ On this, the ______ day of __________________, 20______, before me ________________________, the undersigned officer, personally appeared ________________________ of the State (County or City as the case may be) of __________________ known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he or she executed the same in the capacity therein stated and for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Title of Officer: Type or Print Name My commission expires: Quitclaim Mineral Deed Page 3 of 4 CERTIFICATION OF GRANTEE’S ADDRESS: Grantee Name and Address: I hereby certify under penalty of perjury that the above information is true and accurate. Date: Signature Rank/Position __________________ Quitclaim Mineral Deed Exhibit A EXHIBIT A