Form Ogb-1e - Application For Change Of Operator - State Oil And Gas Board Of Alabama

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STATE OIL AND GAS BOARD OF ALABAMA

OGB-1E

Application for Change of Operator

_______________________________________

____________________________________________

Form OGB-1E, Rev. 07/13

Permit Number

API Number

(

)

If multiple wells, list in remarks or on attachment

(File in triplicate)

Name of new operator _________________________________________________________________________________________________

Address _______________________________________________ City _____________________ State ___________ Zip ______________

Contact __________________________ Phone # _______________ Fax # _______________ E-Mail ______________________________

Name of present operator ______________________________________________________________________________________________

Address _______________________________________________ City _____________________ State ___________ Zip ______________

Contact __________________________ Phone # _______________ Fax # _______________ E-Mail ______________________________

Remarks: List well(s) and permit number(s) below or on attachment

The undersigned representing the present operator and new operator, hereby apply to change the operator for the well or wells named

above, including all associated production facilities, processing facilities, injection facilities, plants, gathering lines, pipelines, and other

associated facilities or equipment. Further, the undersigned representing the new operator, acknowledges that it has ownership or

control of one hundred percent (100%) of the rights to drill and produce with respect to oil and gas underlying the lands comprising the

unit assigned to the well or wells or to conduct Class II Well Operations on and under the lands on which the well or wells is located for

which a change of operator is requested.

________

________________________________________________________

Executed this the _______ day of __________

, 20 __

Signature New Operator

________________________________________

Before me, the undersigned authority, on this day personally appeared

known to me to be the person

whose name is subscribed to the above instrument, who being by me duly sworn on oath states that he/she is duly authorized to make the above report and that

he/she has knowledge of the facts stated therein, and that said report is true and correct.

_______

____________________

_________

Subscribed and sworn to before me this

day of

, 20

_____________________________________

SEAL

_____________________

Notary Public in and for

____________________

My commission expires

________________________________

County,

________

________________________________________________________

Executed this the _______ day of __________

, 20 __

Signature Present Operator

________________________________________

Before me, the undersigned authority, on this day personally appeared

known to me to be the person

whose name is subscribed to the above instrument, who being by me duly sworn on oath states that he/she is duly authorized to make the above report and that

he/she has knowledge of the facts stated therein, and that said report is true and correct.

_______

____________________

_________

Subscribed and sworn to before me this

day of

, 20

_____________________________________

SEAL

_____________________

Notary Public in and for

____________________