Fill and Sign the Affidavit of Compliance with Terms of Oil and Gas Lease Form

AFFIDAVIT OF COMPLIANCE WITH TERMS OF OIL AND GAS LEASE(By Lessee) STATE: COUNTY: Before me, the undersigned authority, on this day personally appeared (Name of Affiant), known to me to be the person whose name is subscribed to this Affidavit, who after having been first duly sworn, deposes and under oath stated:My name is ______. My address is _____. I am employed as (e.g., Landman, Vice President, etc.) of (Name of Company), the Lessee in the Oil and Gas Lease (the “Le ase”) dated ______, between ______, as Lessor and ______, as Lessee. The Lease is recorded in Volume ______, page ______ of the ______ Records of ______ County, ______. The Lease covers the following lands in ______ County, ______. (Description of Lands) The Lease imposes certain obligations on the Lessee. These obligations are as follows: (List Specific Obligations Which the Lease Imposes Upon Lesseeto Enable the Lessee to Maintain the Lease in Force and Effect) I am personally aware that Lessee named in the Lease has accomplished the following activities for purposes of complying with the terms of the Lease, in order to mainta in the Lease in force and effect as to all the lands it covers: (Identify activities which Lessee engaged in to perpetuate the Lease: e.g., dril ling wells within a certain period of time; conducting seismic activity and exploration; e ngaging in continuous development; etc.) Having completed these activities, the Lessee named in the Lease is deeme d to have complied with all of the terms of the Lease and deems the Lease, as to all of the lands covered by it, to be maintained and in force and effect as of the date of this Affidavit. Date: Affiant (Jurat) (Acknowledgment)