AFFIDAVIT OF POSSESSION INFORMATION SHEET

I.

BACKGROUND INFORMATION
A) Tract Name: ____________________________________________________________________________
B) Brief Tract Description: ___________________________________________________________________
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C) County or Parish: ________________________________________________________________________
D) Date of Interview: _______________________________________________________________________
E) Affiants Full Name: _____________________________________________________________________
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F) Affiants Age: ___________________________________________________________________________
G) Affiants Date of Birth: ___________________________________________________________________
H) Affiants Place of Birth: ___________________________________________________________________
I) Affiants Current Address: __________________________________________________________________
J) Affiants Length of Residency at Current Address: _______________________________________________
K) Affiants Residence Relative to Subject Tract: _________________________________________________

II. PERTINENT QUESTIONS

A) Have there ever been any adverse claims against the tract in question? ______________________________
If the answer is yes, have affiant explain. ________________________________________________________
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B) Have there ever been any boundary disputes involving the tract in question? __________________________
If the answer is yes, have affiant explain. ________________________________________________________
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C) Have any wells ever been drilled on the tract in question? _________________________________________
Has the tract in question ever been unitized? ___________________________________________________
1) When was the well drilled? ______________________________________________________________
2) What was the total depth? _______________________________________________________________
3) Did the well produce or was it a dry hole? __________________________________________________
a) When did production cease? __________________________________________________________
b) Was the well plugged? ______________________________________________________________
c) When was the well plugged? __________________________________________________________
D) Has there ever been a search for any minerals other than Oil or Gas? ________________________________

If yes, explain ______________________________________________________________________________

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E) Are there any churches located on the tract in question? __________________________________________
1) What is the name of the Church? __________________________________________________________
2) Where is the approximate location relative to the tract in question? _______________________________
F) Are there any schools located on the tract in question? ___________________________________________
1) What is the name of the school? __________________________________________________________
2) Where is the approximate location relative to the tract in question? _______________________________
G) Are there any cemeteries located on the tract in question? ________________________________________
1) What is the name of the cemetery? ________________________________________________________
2) Where is the approximate location relative to the tract in question? _______________________________
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H) Are there any houses located on the tract in question? ____________________________________________
1) Where is the approximate location relative to the tract in question? _______________________________
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I) Are there any Barns located on the tract in question? _____________________________________________
1) Where is the approximate location relative to the tract in question? _______________________________
J) Are there any outbuildings located on the tract in question? ________________________________________
1) Where is the approximate location relative to the tract in question? _______________________________
K) Have there been any drainage or other soil conversation measures carried out on the tract in question? _____
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L) What are the boundary lines of the tract in question? (include: kind, condition, who built, any repairs,
position, etc.)
1) North: _______________________________________________________________________________
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2) East: ________________________________________________________________________________
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3) South: _______________________________________________________________________________
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4) West: _______________________________________________________________________________
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5) Any additional boundary information: _____________________________________________________
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M) What is the chain of title?
1) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________
c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________
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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________
2) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________
c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________

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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________
3) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________
c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________
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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________
4) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________
c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________
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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________
5) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________

c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________
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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________
6) Occupancy
a) Who owned the tract in question? ______________________________________________________
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b) Did they live on the tract in question? ___________________________________________________
c) How did they use the tract in question? (e. g. timber, farming, pasture, type crops, etc.) ____________
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d) Were there any tenants on the tract in question? ___________________________________________
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e) When did the owner sell the tract in question? ____________________________________________