ALTA Leasehold Loan Policy (1992)
Policy No.: M-9995-
Date of Policy at a.m./p.m.
Amount of Insurance:
1. Name of Insured:
2. The estate or interest in the land described or referred to and covered herein is the leasehold estate, in Indian lands [e.g., land held in trust for an Indian Tribe, band, community, group, pueblo ("Tribe"), or land held by any of the above subject to restrictions against alienation or encumbrance], created by the instrument herein referred to as the Lease which is identified as follows:
Instrument No. or Volume/Page, etc.:
3. Title to the estate or interest in the land is vested in:
4. The insured mortgage and assignments, if any, are described as follows:
5. The land referred to in this policy is described as follows:
A portion of the ___________________ (name of Tribe or reservation) lands described as follows:
No guidelines are available for this form at this time.