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Fill and Sign the State of Countyparish of Affidavit of Form

Fill and Sign the State of Countyparish of Affidavit of Form

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AFFIDAVIT AS TO LESSOR BEING OF SOUND MINDON DATE OIL AND GAS LEASE WAS EXECUTED State: County: Affiant: (Name and Address) Before me, the undersigned authority, on this day personally appeared (Name of Affiant), known to me to be the person whose name is subscribed to this Affidavit, who after having been first duly sworn, deposes and under oath stated:My name is ____, and I am well familiar with (Name of Lessor) who executed an Oil and Gas Lease (the "Lease") dated ____, to (Name of Lessee). The Lease is recorded in Vol ume ____, page ____ of the ____ Records of ____ County, ____. I have known (Name of Lessor) for ____ years and have dealt with (Name of Lessor) personally and been involved in business transactions with (Name of Lessor) during that period of time. During that entire period of time and up to the date of this Affidavit, (Name of Lessor) has always appeared and is deemed by me to be of sound mind, fully knowledgeable of (his/her) business and business dealings, and able to make decisions on (his/her) own behalf in dealing with property and assets (he/she) owns. Affiant Date: (Jurat) (Acknowledgment)

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