Landowner Plaque Nomination Form Link from Historic Texas Lands Plaque, Under State Archeology

Texas Landowner’s Plaque Nomination Form

Would you like to be a Historic Texas Lands landowner, or recommend someone else for the honor? Please complete the following:

Landowner’s Name: ________________________________________

Number/Street/P.O. Box : ____________________________________

City: ____________________ Zip Code: ________________________

Phone Number: (_____)______________________________________

Email Address: _____________________________________________

Person referring landowner to the THC (if different from above):

Referrer’s Name: ____________________________________________

Referrer’s Phone Number: _____________________________________

Referrer’s Email Address: ______________________________________

Please discuss how you or the person you are recommending qualifies for a Historic Texas Lands plaque. Attach additional pages as needed:

If I receive a Historic Texas Lands plaque, I pledge to display it on a ranch gate or other visible place on my land.

Landowner’s Signature: ____________________________ Date: ___________

If you would like to discuss this information with a THC regional archeologist, please phone 512/463-6096, or email . Mailing address: Archeology Division, Texas Historical Commission, P.O. Box 12276, Austin TX 78711-2276.