West Virginia Mineral Development
Mineral Lease Nomination Form
Date:
*
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Month
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Day
Year
Date Picker Icon
Property Information
Legal Description:
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District:
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Tax Map:
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Parcel:
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County:
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Net Acreage:
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If it’s under the Ohio River, please provide the applicable mile post.
Contact Information
Name:
*
Address:
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City:
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State:
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Zip Code:
*
Phone:
*
Fax:
E-mail:
*
Submit
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