LEAVE A LEGACY:

LAND BANKING ACQUISITION FORM

The Texas Historical Commission (THC) has the legal authority to acquire property in accordance with its responsibilities as the state agency for historical preservation and exercises this authority by various means, including land banking.Land banking involves the acquisition of highly significant historic properties to ensure their long-term preservation. These properties are not intended to be interpreted or open to the public.

Use this form to offer property of archeological and/or historical significance in Texas to the THC for preservation purposes. Completion and submission of this form is a required step in the land banking application process. Acceptance of a completed form by the THC only signifies the acceptance of the application for review.

SECTION 1: SUBMISSION

To submit the acquisition form, send it via mail or private express mail to:

Mailing address:
Texas Historical Commission
Leave a Legacy Acquisition Form
P.O. Box 12276
Austin, TX 78711-2276 / Street address for private express mail:
Texas Historical Commission
Leave a Legacy Acquisition Form
1511 Colorado Street
Austin, TX 78701
512/463-6100

Please provide the following in your package:

  • One completed acquisition form with original signatures
  • One CD-R media disc with digital photographs as described in Section 6: Photograph Requirements
  • All pertinent attachments
  • If needed, attachment listing all property owners
SECTION 2: PROPERTY OWNER INFORMATION

A. List all property owners.Attach additional sheet(s) if needed, listing any additional owners (Label as Attachment A., Property Owners).

Property Owner #1 Name:
Address:
City/State/Zip:
Telephone/Fax:
E-mail:
Property Owner #2 Name:
Address:
City/State/Zip:
Telephone/Fax:
E-mail:
Property Owner #3 Name:
Address:
City/State/Zip:
Telephone/Fax:
E-mail:

B. Required Property Owner Signature(s)

I, [print name], certify that I am the/an (circle one) owner of the property described in Section C, below. I further certify that I am offering said property to the Texas Historical Commission for acquisition. This offer includes (check all that apply):

Surface rights / Mineral rights
Property owner #1 / Date

I, [print name], certify that I am an owner of the property described in Section C, below. I further certify that I am offering said property to the Texas Historical Commission for acquisition. This offer includes (check all that apply):

Surface rights / Mineral rights
Property owner #2 / Date

I, [print name], certify that I am an owner of the property described in Section C, below. I further certify that I am offering said property to the Texas Historical Commission for acquisition. This offer includes (check all that apply):

Surface rights / Mineral rights
Property owner #3 / Date

If there are additional property owners, attach additional sheet(s) with the following statement for each to complete, sign and date. Label as Attachment B, Required Property Owner Signatures:

I, [print name], certify that I am an owner of the property described in Section C, below. I further certify that I am offering said property to the Texas Historical Commission for acquisition. This offer includes (check all that apply):

Surface rights / Mineral rights
Property owner #___ / Date

C. List all mineral rights owners.Attach additional sheet(s) if needed, listing any additional owners (Label as Attachment C., Mineral Rights Owners). If mineral rights owners are unknown, write “unknown” on first line of table below.

Owner Name / Contact Information / Percentage of Rights

SECTION 3: ACQUISITION TYPE

Donation / Purchase

If property is being offered for purchase, indicate the purchase price:

SECTION 4: PROPERTY DESCRIPTION AND LOCATION— a separate application form must be completed for each offered property.

Property Name

Archeological Site Name & Trinomial (if applicable)

Property Type (check all that apply)

Archeological / Architectural

Acquisition Type Offered

Donation / Sale

*If the offered property is for purchase, list the suggested sale price:

Briefly describe the property, providing details such as dates or periods, cultural affiliations or styles:

Property address—if applicable:

Street:
City/State/Zip:

or

Description of property location (including nearest city or town, road or highway names, etc.)

County(ies) in which property is located

Legal description of property (survey, block, lot, etc.)

USGS Quadrangle* name(s) and number(s)

*A copy of the USGS quadrangle must be included with the application showing the location and site boundaries of the offered property.

For archeological properties, include all pertinent UTMs:

UTM Zone: (NAD27 datum)

Centroid: Easting Northing

or

NE Corner: EastingNorthing

SE Corner: Easting Northing

SW Corner: Easting Northing

NW Corner: Easting Northing

SECTION 5: ACKNOWLEDGEMENTS — bychecking each box below, the applicant acknowledges:

A Metes and Bounds survey is required.

A reconnaissance or cultural resources survey of the offered property is required.

Archeological sites present on the offered property must be recorded and filed with the Texas Archeological Research Laboratory (University of Texas at Austin).

Test excavations of archeological sites located on the offered property and/or archival research may be necessary in order to establish the property’s archeological and/or historical significance.

Significant sites on the property must be nominated for State Archeological Landmark designation.

THC commissioners will consider and vote on approval of the property acquisition.

SECTION 6: PHOTOGRAPHIC/IMAGE REQUIREMENTS

Include at least four images of the property showing cardinal directions (if an archeological site) and any visible cultural features. For architectural properties include at least four exterior photograph as well as significant interior public spaces, outbuildings and surrounding site features. All photographs should be submitted digitally. Please verify that the image sizes are at least 100 kb (kilobytes) and no larger than 1 mb (megabyte). It is recommended that digital images be save in 8-bit (or larger) color format, which provides maximum detail. The file name for each image should be county_propertyname_view_.jpg).

SECTION 7: ATTACHMENTS— check the appropriate box for any attachment(s) enclosed with this form

Metes and Bounds survey

Reconnaissance or cultural resources survey report/assessment

Archeological site records

SAL nomination form, with letter notification of designation (if available)

CD-R media disc with digital photographs as described in Section 6.

Other materials (list any additional items)

Land Banking Acquisition Form

Page 1 of 6

01/12/09