Fill and Sign the Louisiana Servitude Agreement Form

STATE OF LOUISIANA PARISH OF [_PARISH_] SERVITUDE AGREEMENT BEFORE ME, the undersigned Notary Public, duly commissioned and qualified in and for the state and parish aforesaid, and in the presence of the good and competent witnesses, PERSONALLY CAME AND APPEARED: [_GRANTOR_1_] , whose Tax Identification Number is [_TIN_1_] , and [_GRANTOR_2_] , whose Tax Identification Number is [_TIN_2_] , husband and wife domiciled in [_Grantor_Parish_] , whose present mailing address is [_Grantor_Address_] ; hereinafter referred to jointly as "GRANTOR"; and [_GRANTEE_] , whose Tax Identification Number is [_TIN_3_] , a Louisiana corporation domiciled and having its principal place of business at [_Grantee_Address_] , represented herein by [_AGENT_] , its [_Office_] duly authorized; hereinafter referred to as "GRANTEE", who after being duly sworn, did depose and say: That GRANTOR is the owner of the following described property: [_Property_Description_] The property conveyed herein has as its address [_Prop_Address_] . In consideration of [_$Price_] and other good and valuable consideration, GRANTOR does grant and convey to GRANTEE a servitude or right of way across the property described above for the construction and maintenance of [_Describe_] . The servitude shall be [_Location_] . Construction and maintenance of the improvements and facilities shall be at GRANTEE's cost and the rights granted herein shall be exercised [_Restrictions_] . In exercise of this servitude, GRANTEE may not permit the presence, use, disposal, storage or release of any hazardous substances upon the property described above. Thus done and passed on [_Date_] , at [_City_Parish_] , Louisiana. Witnesses: _____________________ _________________________ [_GRANTOR_1_] _____________________ _________________________ [_GRANTOR_2_] [_GRANTEE_] BY: _____________________ [_AGENT_] - 1 - [_Office_] _________________________________ [_NOTARY_] , NOTARY PUBLIC * * * * * * * * * * SERVITUDE AGREEMENT - F1ASAL13 : This instrument conveys a servitude across specified property and contains restrictions as to use and location. See R.S. 9:2726 for requirement of plat, sketch or aerial photograph for certain servitudes. WORD KEY : EXPLANATION : [_PARISH_] Parish of execution. [_GRANTOR_1_] Full name of first grantor. For alternative appearances, see document Appearances - F1AAPP1. [_TIN_1_] Tax Identification Number of first grantor. [_GRANTOR_2_] Full name of second grantor [_TIN_2_] Tax Identification Number of second grantor. [_Grantor_Parish_] Parish of grantors' domicile. [_Grantor_Address_] Mailing address of grantors. [_GRANTEE_] Full name of grantee, in this case a corporation. For alternative appearances, see document Appearances - F1AAPP1. [_TIN_3_] Tax Identification Number of grantee. [_Grantee_Address_] Mailing address of grantee's principal place of business. [_AGENT_] Name of person appearing for grantee. [_Office_] Office held by person appearing for grantee. [_Property_Description_] Description of property, including acquisition. [_Prop_Address_] Municipal number or address of the property affected. [_$Price_] Price paid for servitude (with $). [_Describe_] Describe purpose of servitude and improvements to be installed. [_Location_] Describe location of servitude on property. If the servitude is shown on an attached plat, sketch or aerial photograph, make appropriate reference. - 2 - [_Restrictions_] State restrictions on construction and use of servitude. [_Date_] Date act is signed. [_City_Parish_] City and parish of signing. [_NOTARY_] Notary before whom act is signed. - 3 -