IR-9B Evidence of Title.pdf

IR-9B Evidence of Title is a form issued by the State of West Virginia Department of Environmental Protection Office of Oil and Gas for documenting property ownership related to abandoned and orphaned wells. The form serves as a title verification document requiring comprehensive identification of all parties with interests in the well and surrounding property. Key sections include well identification information (API number, operator, assigned number, well number), well location details (quadrant, district, county, latitude, longitude), and identification of surface estate owners with supporting deed references and maps showing well location and parcel boundaries. The form requires documentation of oil and gas mineral estate ownership, coal estate ownership (including coal owner declarations, coal lessee declarations, and coal operator information), with all parties identified by name, address, and relevant deed book/page references.

The form includes an ownership certification section wherein the submitting party must certify under penalty of contract non-payment that all information provided is correct, accurate, and complete to the best of their knowledge. The submitter acknowledges that falsification, misrepresentation, or omission of facts may result in non-payment under contract terms. The certification requires the signature, printed name, title, and date of the certifying individual. This document is essential for establishing clear chain of title and identifying all stakeholders in abandoned or orphaned well remediation projects undertaken by the state.