CAPTION

ACT OF CORRECTION

STATE OF LOUISIANA:

PARISH OF ______:

KNOW ALL MEN BY THESE PRESENTS:

THAT, ______being a resident of the full age of majority of ______, being hereinafter referred to as “Vendor”, and

THE DEPARTMENT OF TRANSPORTATION AND DEVELOPMENT OF THE STATE OF LOUISIANA, herein represented by CHARLES MCBRIDE, Real EstateAdministrator, authorized by Policy and Procedure Memorandum Number 5, dated December 16, 1976, as amended and revised, issued by the Secretary of the Louisiana Department of Transportation and Development, hereinafter referred to as “Department”, do declare:

THAT, by ______signed ______, filed of record ______, in COB ______, Page ______of the official records of ______Parish, Louisiana, the Department did acquire a certain parcel of land designated as Parcel No. ______, as required for State Project No. ______; and

THAT, the description of Parcel No. ______in said ______did read as follows:

DESCRIPTION OF PROPERTY

THAT, a revision was made by the Department on ______, by which Parcel No. ______was revised, and the description of Parcel No. ______was revised,

THAT, Vendor and the Department agree to reform and correct the description of Parcel No. ______to be in accordance with the revised plans, so that said Parcel No______shall be described as follows:

CORRECTED DESCRIPTION OF PROPERTY

FURTHER, the parties hereto do hereby adopt, ratify and affirm the ______above recited in all of its terms and conditions, except to correct the description of Parcel No. ______as herein provided.

AND, we the parties hereto do hereby authorize the Clerk of Court of ______Parish, Louisiana, to make mention of this Act of Correction in the margin of his records under COB ______, Page ______dated ______, to serve as occasion may require.

IN TESTIMONY WHEREOF, the parties hereto have signed and executed and acknowledged this instrument as their free and voluntary acts, in triplicate originals in the presence of the undersigned competent witnesses, as of the ______day of ______, 20_____.

W I T N E S S E S :

______

______

______

______

______

______

DEPARTMENT OF TRANSPORTATION

AND DEVELOPMENT OF THE STATE

OF LOUISIANA

______

BY:______

CHARLES MCBRIDE

REAL ESTATE ADMINISTRATOR

______

AFFIDAVIT

STATE OF LOUISIANA:

PARISH OF EAST BATON ROUGE:

BEFORE ME, the undersigned authority, this day personally appeared ______, to me personally known to be the identical person whose name is subscribed to the foregoing instrument as an attesting witness, who being first duly sworn on his/her oath, says: That he/she subscribed his/her name to the foregoing instrument as a witness, and that he/she knows ______, who executed the same and saw them sign the same as their voluntary act and deed, and that he/she, the said ______, subscribed his/her name to the same at the same time as an attesting witness.

______

AFFIANT

SWORN TO and subscribed before me, this _____ day of ______, 20____.

______

NOTARY PUBLIC

DEPARTMENT OF TRANSPORTATION

AND DEVELOPMENT OF THE

STATE OF LOUISIANA