Fill and Sign the Utilities District of Western Indiana Remc Home Form

1 EASEMENT REMC Account Number: Street Address: Location: City: STATE OF INDIANA ) ) SS: COUNTY OF ) KNOW ALL MEN BY THESE PRESENTS, that the undersigned (unmarried) (husband and wife) (corporation) (partnership) (unincorporated association hereafter called Grantor, in consideration of its undertaking to construct and operate a system to distribute electricity to residents of the loca lity of the real estate described below, within the above-named county, or within the service territory o f the Grantee, and for other good and valuable consideration, the receipt whereof is hereby acknowledged, does grant unto , Gra ntee, whose post office address is , Indiana, and to its successors and assigns, the right to enter upon the lands of the undersigned, situated in the County of , State of Indiana, and more particularl y described as follows: A tract of about acres situated in County, Township, Range, Grant or Section No. , and more particularly described in Deed Record Book , Page number , as follows: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ and to place, install, construct, bury, operate, repair, maintain, relocate and/or replace thereon or thereunder, and in, under or upon all streets, roads or highways abutting and lands, an electric transmission or distribution line or underground system, or any part thereof, to cut, trim and control the growth by chemical means, machinery or otherwise of trees, shrubbery and vegetation that may interfere with or threaten to endanger the operation and maintenance of said line or system, including any control of the growth of other vegetation in the right-of-way which may incidentally and necessarily resul t from the means of control employed, and to cut down from time to time all dead, weak, leaning or dangerous trees, shrubs and vegetation that are near enough to strike the wires if such trees should fall or which are near enough to an underground system for the roots to interfere with the system, damage the system, or cause a safety hazard. In granting this ea sement, it 2 is understood that at structure locations, only a single structure (and appurtenances) will be used, and that the location of the structure will be such as to form the least possible interference to farm operations (if applicable), as long as it does not materially increase the cost of construction, cause the relocation of existing distribution lines or electric fac ilities or otherwise unduly impinge upon the existing system. Reservation of the full use and enjoyment of the said land insofar as it shall not interfere with the easement here by granted is hereby expressly made. The Grantee is further permitted to license, permit, or otherwise agree to the joint use or occupancy of all poles, lines, trenches, conduits and systems (including underground systems) by any other person, association or corporation for electrification, telephone, cable, television, computer, energy transmission, signal transmission or communication purpose. The undersigned agree(s) that all poles, wires and other facilities, including any ma in service entrance equipment, installed on the above- described land at the Grantee’s expense shall remain the property of the Grantee, removable at the option of the Grantee, upon termination of service to, on or under said lands. The undersigned covenant(s) that he/she/they/it is/are the owner(s) of the land on which this easement is granted and that the lands are free and clear of encumbrances and lie ns of whatsoever character except those held by the following persons except as set forth in attached exhibits. The aforesaid easement runs with the land and includes the rig ht of Grantee or its successors at any time to enter upon the said land, with the necessary t ools and equipment, to service, maintain, repair or otherwise do acts mentioned. It is furt her understood that, whenever necessary, words used in this instrument in the singular shall be construed to read in the plural and that works used in the masculine gender shall be construed to read in the feminine. IN WITNESS WHEREOF, this easement is signed as of the IN WITNESS WHEREO F, this easement is signed as of the day of , 20 . Grantor STATE OF INDIANA ) ) SS: COUNTY OF ) Before me the undersigned, a Notary Public for and in , personally appeared the Grantor whose County, State of Indiana, personally appeared the Grantor whose signature appears above and acknowledged the execution of the signature appears above and acknowledged the execution of the foregoing instrument as his/her/their 3 free and voluntary act this foregoing instrument as his/her/their free and voluntary act this day of 20 . (N.P Seal) Notary Public Printed or Typed Name Resident of County, Indiana. My commission expires: This document prepared by . I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by law. _______________________________ (Name of Preparer)