Notice Of Transfer Of Oil And Gas Wells - Form 15

Notice of Transfer of Oil and Gas Wells - Form 15 Department of Mineral Resources Oil and Gas Division 600 East Boulevard Dept 474 Bismark, N.D 58505 to 0614 S.F.N 5762 (03 to 2000)

Field: for State Use Only ndic Bond Number

Please Read Instructions Before Filling Out Form . Please Submit the Original and Six Copies.

This Notice Along with A Fee of $25.00 Per Well Shall be Filed at Least Thirty Days Before the Closing Date of Transfer

Transferring Operator

Field: Reset View Print

Field: Name of Operator Representative

Field: Telephone Number

Field: Operator Transferring Oil and/or Gas Wells

Field: Address

Field: City

Field: State

Field: Zip Code

I, the above named representative, acknowledge the transfer of the oil and/or gas wells named below for the purpose of ownership and/or operation to the company named below.

Field: Signature

Field: Title (Must be an officer or power of attorney must be attached)

Field: Date

Field: Well File Number

Field: Requested Official Well Name and Number

Field: Location (Qtr-Qtr, S-T-R)

Field: Assignment Date

Receiving Operator

Field: Name of Operator Representative

Field: Telephone Number

Field: Operator Receiving Oil and/or Gas Wells

Field: Address

Field: City

Field: State

Field: Zip Code

I, the above named representative, have read the foregoing statement and accept such transfer, also the responsibility of ownership and/or operation of said well or wells, under the said company bond, said bond being tendered to or on file with the Industrial Commission of North Dakota.

Field: Signature

Field: Title (Must be an officer or power of attorney must be attached)

Field: Date

Surety Company

Field: Surety

Field: Telephone Number

Field: Amount of Bond $

Field: Address

Field: City

Field: State

Field: Zip Code

Field: Bond Number

The above named Surety agrees that such bond shall extend in compliance with Chapter 38 to 08 of North Dakota Century Code and amendments and the rules and regulations of the Industrial Commission of North Dakota prescribed to govern the production of oil and gas on government and private lands within the State of North Dakota, in relation to the above stated transfer; it being further agreed and understood that the bond sum or amount is not to be considered increased because of such extension.

Field: Signature

Field: Title (Must be an officer or power of attorney must be attached)

Field: Date

for State Use Only

Field: Printed Name

Field: Date Approved

Field: By

Field: Title

Notice of Transfer of Oil and Gas Wells - Form 15 S.F.N 5762

1. Please refer to Section 43-02-03-15 of the North Dakota Administrative Code regarding transfer of wells.

2. The operator of a well shall be the principal on the bond covering the well.

3. The operator, well file number, and well location shall coincide with the official records on file with the Commission.

4. Transfer of property does not release the bond. In case of transfer of property or other interest in the well and the principal desires to be released from the bond covering the well, the principal shall notify the Director, in writing, on a Notice of Transfer of Oil and Gas Wells - Form 15 (S.F.N 5762) at least thirty (30) days before the closing date of the transfer. The Director may, for good cause, waive the requirement of at least thirty (30) days' notice prior to transfer. A fee of $25.00 per well shall accompany the notice.

5. The date of assignment or transfer shall be reported.

6. When the Commission has approved the transfer and accepted it under the transferee's bond, the transferor shall be released from the responsibility of plugging the well and site reclamation.

7. The transferee (new operator) of any well shall be responsible for the plugging and site reclamation of said well. For that purpose the transferee shall submit a new bond or, in the case of a surety bond, produce the written consent from the surety of the original or prior bond that the latter's responsibility shall continue.

8. The surety company shall be a responsible surety company authorized to transact business in North Dakota.

9. The bond number in the surety block is a number assigned by the surety company.

10. The Commission may refuse to transfer wells if the transferring operator, receiving operator, or surety company has failed in the past to comply with statutes and rules relating to the operation of wells, or if a civil or administrative action brought by the Commission is pending against either the operator or the surety company.

11. The original and six copies of this notice shall be filed with the Department of Mineral Resources, Oil and Gas Division, 600 East Boulevard, Dept. 474, Bismarck, N.D 58505 to 0614.