Authorization To Purchase And Transport Oil From Lease - Form 8

Authorization to Purchase and Transport Oil from Lease - Form 8 Department of Mineral Resources Oil and Gas Division 600 East Boulevard Dept 474 Bismark, N.D 58505 to 0614 S.F.N 5698 (03 to 2000)

Field: Well File No.

Please Read Instructions Before Filling Out Form.

Please Submit the Original.

Field: Well Name and Number

Field: Qtr-Qtr

Field: Section

Field: Township

Field: Range

Field: County

Field: Operator

Field: Telephone Number

Field: Field

Field: Address

Field: City

Field: State

Field: Zip Code

Field: Name of First Purchaser

Field: Telephone Number

Field: % Purchased

Field: Date Effective

Field: Principal Place of Business

Field: City

Field: State

Field: Zip Code

Field: Field Address

Field: City

Field: State

Field: Zip Code

Field: Name of Transporter

Field: Telephone Number

Field: % Transported

Field: Date Effective

Field: Address

Field: City

Field: State

Field: Zip Code

The above named producer authorizes the above named purchaser to purchase the percentage of oil stated above which is produced from the lease designated above until further notice. The oil will be transported by the above named transporter.

Field: Other First Purchasers Purchasing From This Lease

Field: % Purchased

Field: Date Effective

Field: Other First Purchasers Purchasing From This Lease

Field: % Purchased

Field: Date Effective

Field: Other Transporters Transporting From This Lease

Field: % Transported

Field: Date Effective

Field: Other Transporters Transporting From This Lease

Field: % Transported

Field: Date Effective

Field: Comments

I hereby swear or affirm that all transporters of Bakken Petroleum System oil listed above implement or adhere to a tariff specification as stringent as the Commission's V.P.C.R requirement.

Field: V.P.C.R Tariff Specification

Field: Tariff Authority

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.

Field: Date

Field: Signature

Field: Printed Name

Field: Title

Above Signature Witnessed By

Field: Witness Signature

Field: Witness Printed Name

Field: Witness Title

for State Use Only

Field: Date Approved

Field: N.D.I.C C.T.B No

Field: By

Field: Title

Authorization to Purchase and Transport Oil from Lease - Form 8 S.F.N 5698

1. The operator shall file and receive an approved Authorization to Purchase and Transport Oil from Lease - Form 8 (S.F.N 5698) before any crude oil is transported from a well, central production facility, or any other facility that oil is sold from. Please refer to Section 43-02-03-81 of the North Dakota Administrative Code (N.D.A.C).

2. If necessary, the operator may obtain verbal transport to oil prior to receipt of an approved Authorization to Purchase and Transport Oil from Lease - Form 8 (S.F.N 5698) by contacting the Bismarck office of the Commission.

3. After notice and hearing the commission may revoke the Authorization to Purchase and Transport Oil from Lease - Form 8 (S.F.N 5698) for failure to comply with any rule, regulation, directive of the director or of the Commission.

4. Oil transported before authorization is obtained or if such authorization has been revoked shall be considered illegal oil.

5. The operator shall file a new Authorization to Purchase and Transport Oil from Lease - Form 8 (S.F.N 5698) for approval if there is any change of information contained therein on an Approved Form 8 (S.F.N 5698) on file with the Commission.

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

7. If the method of transportation changes such that V.P.C.R tariffs are no longer as stringent as those set forth by the Commission, the operator must adhere to other methods to obtain compliance as authorized in Oil Conditioning Order 31092, Policy/Guidance Version 082020.

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