Example TX Policy Form - Insuring One Fee Parcel and Two Easement Estates 1

SCHEDULE A

GF NO.

Date of Policy:

Owner Policy No.: -5841-

Amount of Insurance: $

1. Name of Insured:

2. The estate or interest in the land which is covered by this policy is:

Fee simple as to Parcel I

Easement Estates as to Parcels II and III.

3. Title to the estate or interest in the land is Insured as vested in:

4. The land referred to in this policy is described as follows:

PARCEL I:

Lot 17, Block 22, INDIAN CHIEF, a subdivision of land in ___________ (City, if within any), __________ County, State of __________, according to the recorded plat of said subdivision.

PARCEL II:

A non-exclusive easement for ________ purposes, appurtenant to Parcel I, as established by the instrument recorded in Book _____, Page _____, over the following described area: ___________________________________________________________________

_________________________________________________.

PARCEL III:

A non-exclusive easement for __________ purposes, appurtenant to Parcel I, as established over the instrument recorded in Book _____, Page _____, over the following described area: ___________________________________________________________________

_________________________________________.