“ , the owner and possessor of the surface rights to the (Name) real property described below, do hereby state, affirm and give notice to any missing or absent claimants, whose whereabouts are unknown, to said real property of my intent to oust said missing or absent claimant, who has made no written claim for rents, profits or possession of said real property during the last twenty (20) years and intend to institute an action to quiet title to such real property. The real property referred to is described as follows: Subscribed and sworn to before me this day of ,
(Seal)”
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