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Harvey Building (middle photo) - Photo courtesy of Historical Society of Palm Beach County

SURFACE RIGHTS WAIVER
INFORMATION REQUEST FORM

Information on Title Company, Attorney or other requesting firm

Name:

Address:

City:

State:

Zip Code:

Phone:

Fax:

Email: 
Information on Buyer and Property

Name:

Address:

City:

State:

Zip Code:

Phone:

Fax:

Email: 
Property Information

County:

Township:

Range:

Section:

Legal
Description:

Physical
Address:

# of Acres:

Intended Use:

Total Price:

 $

Basis for
determination
of price:

Other:
Southern States Land & Timber LLC Surface Rights Waiver Fee Terms

Sequential fees are charged for waiver of surface access rights to owner and for our commitment to extend the waiver to the next owner at a known or determinable fee.

Fee is a percentage of the sales price or FMV, subject to a minimum fee per acre for one acre or less than one acre.

Minimum fees escalate after 5 years based on change in Consumer Price Index.

Upon receipt of this completed form and fee, Southern States will forward executed document to above listed Title Company, unless instructed otherwise. Please mail appropriate fee, payable to Southern States Land & Timber LLC, to the address shown below:

Southern States Land & Timber LLC
P. O. BOX 333
Franklin, LA 70538

 

    

203 MAIN STREET, P. O. BOX 333, FRANKLIN , LA 70538     •    Toll-free: (877)858 2758     •    Ph: (337)828 9155     •    Fax: (337)828 7732     •    Email: info@ssltllc.com

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