Fill and Sign the Louisiana Mineral Deed Form

STATE OF LOUISIANA PARISH OF [_PARISH_] MINERAL DEED BE IT KNOWN, that on [_Date_] before me, [_NOTARY_] , Notary Public, duly commissioned and qualified, and in the presence of the undersigned witnesses, personally came and appeared: [_SELLER_1_] , Tax Identification Number [_TIN_1_] , and [_SELLER_2_] , Tax Identification Number [_TIN_2_] , husband and wife domiciled in [_Seller_Parish_] , and whose present mailing address is [_Seller_Address_] , hereafter referred to jointly as "SELLER"; who declared that for the price of [_PRICE_] ( [_$Price_] ) DOLLARS cash, receipt of which is acknowledged, SELLER hereby sells and delivers, without any warranty or guaranty of title whatsoever, even for restitution of the purchase price, but with subrogation to all its rights and actions of warranty against previous owners, unto: [_PURCHASER_1_] , whose Tax Identification Number is [_TIN_3_] , and [_PURCHASER_2_] , whose Tax Identification Number is [_TIN_4_] , husband and wife domiciled in [_Purchaser_Parish_] , and whose present mailing address is [_Purchaser_Address_] , hereafter referred to jointly as "PURCHASER"; present, accepting and acknowledging possession for PURCHASER and PURCHASER's successors and assigns, all of the oil, gas and minerals in, under and which may be produced from the following described property: [_Property_Description_] It is the express intention of SELLER to convey a mineral servitude herein, and not only a mineral royalty, but SELLER and PURCHASER agree that the surface of the land shall not be used for the exploration for or development of any mineral. This conveyance is made subject to the terms and provisions of all valid existing oil, gas and mineral leases now in force and affecting the lands described above. All parties signing the within instrument have declared themselves to be of full legal capacity and have declared that the name, marital status, domicile and address of each is correct as set forth above. Appearers recognize that, except to the extent separately certified in writing, no title examination of said property has been performed by any undersigned Notary. THUS DONE AND PASSED at [_City_Parish_] , Louisiana, in the presence of the undersigned competent witnesses, who sign with appearers and me, Notary, after due reading of the whole. WITNESSES: _____________________ __________________________ - 1 - [_SELLER_1_] _____________________ __________________________ [_SELLER_2_] __________________________ [_PURCHASER_1_] __________________________ [_PURCHASER_2_] __________________________________ [_NOTARY_] , NOTARY PUBLIC, NOTARY PUBLIC - 2 - MINERAL DEED - F1ASAL16: This is a sale of a mineral servitude, without warranty of title and without the right to use the surface of the affected property for exploration or development activities. This form assumes that the property affected is not located in a municipal corporation exceeding 300,000 in population (See R.S. 9:2921 for additional document requirements), or in the Parish of Orleans (See R.S. 9:2928 for additional requirements). WORD KEY : NOTE : [_PARISH_] Parish of execution. [_Date_] Date of execution. [_NOTARY_] Notary before whom act is executed. [_SELLER_1_] Full name of first seller. This form uses appearances for married sellers and purchasers. For alternative appearances, see document Appearances - F1AAPP1. [_TIN_1_] Tax Identification Number of first seller. For discussion of Internal Revenue Service reporting requirements, see document Request for Tax Identification Number - F1ASAL14. [_SELLER_2_] Full name of second seller. [_TIN_2_] Tax Identification Number of second seller. [_Seller_Parish_] Parish of sellers' domicile. [_Seller_Address_] Address of sellers. [_PRICE_] Price in words. [_$Price_] Price in numerals (with $). [_PURCHASER_1_] Full name of first purchaser. [_TIN_3_] Tax Identification Number first purchaser. [_PURCHASER_2_] Full name of second purchaser. [_TIN_4_] Tax Identification Number of second purchaser. [_Purchaser_Parish_] Parish of purchasers' domicile. [_Purchaser_Address_] Address of purchasers. [_Property_Description_] Description of property that is to be subject to the mineral servitude conveyed. [_City_Parish_] City and parish of execution. - 3 -