Fill and Sign the Assignment Oil Gas Form

STATE OF       COUNTY OF       ASSIGNMENT OF OIL, GAS AND MINERAL LEASES, OVERRIDING ROYALTY INTERESTS, MINERAL INTERESTS AND ROYALTY INTERESTS KNOW ALL PERSONS BY THESE PRESENTS, that reference is hereby made for all purposes (particularly for a precise description of the lands covered and affected thereby) to those certain Oil, Gas and Mineral Leases, Assignments of Overriding Royalty, Royalty Deeds and Mineral Right and Royalty Transfer instruments, or assignments or transfers of interest therein or the property affected thereby (hereinafter collectively referred to simply as the "Interests") set forth on the Schedule thereof which is attached hereto, and made a part hereof as Exhibit "A," which said Interests are recorded in the records of       County, State of       .       , the personal representative of the Estate of       , Deceased, and the Co - Trustee and Delegate of       , Co - Trustee of the Revocable Trust Agreement of       under Amended and Restated Revocable Trust Agreement dated       , 20       , Distributee of the Estate of       , Deceased (hereinafter referred to simply as "Assignor) for and in consideration of the price of       Dollars ($       ), cash in hand paid, has granted, bargained, sold, conveyed and by these presents does grant, bargain, sell and convey unto       , a widow/widower , whose address is       ,       ,       ,             , and whose Tax Identification Number is       , to the extent of an undivided       percent (       %) interest;       a       limited liability company, whose manager is       , whose mailing address is       ,       ,             , whose physical address is       ,       ,             , and whose Taxpayer Identification Number is       , to the extent of an undivided       percent (       %) interest;       , husband of       , whose mailing address is       ,       ,             , whose physical address is       ,       ,       ,       , and whose Tax Identification Number is       , to the extent of an undivided       percent (       %) interest;       , an       corporation, whose address is       ,       ,             , and whose Tax Identification Number is       , to the extent of an undivided       percent (       %) interest;       , a       corporation, whose mailing address is       ,       ,             , and whose Tax Identification Number is       , to the extent of an undivided       percent (       %) interest; and       , husband/wife of       , whose mailing address is       ,       ,             , and whose Tax Identification Number is       to the extent of an undivided       percent (       %) interest, herein collectively called Assignees, in the proportions stated, all of the Interests owned by Assignor and established or created by the instruments set forth on Exhibit “A” or affecting and relating to the lands set forth on Exhibit “A” located in       County, State of       . The Interests herein sold and conveyed by Assignor unto Assignees are all of the mineral rights, royalty rights, overriding royalty rights and leasehold working interest estates acquired by Assignor or by its predecessors - in - title,       ,       or       by virtue of the instruments listed and set forth in Exhibit “A” attached hereto or the property affected thereby and owned by Assignor. And for the same consideration, Assignor also conveys unto the Assignees, in the proportions above stated, any and all other mineral royalty, overriding royalty and lease - hold working interest owned by Assignor located in the aforesaid county and state. This sale and       is made and accepted subject to any valid oil, gas and mineral lease of record now affecting said lands, mineral rights and royalty interests, but the royalties hereinabove described shall be delivered and paid to the Assignees out of and deducted from the royalties reserved to the Lessor in any of said leases affecting said lands. This sale and transfer, however, is not limited to royalties accruing under any valid lease presently affecting said lands, but the royalty rights herein conveyed are and shall remain a charge and burden on the land herein described and binding on any future owners or lessees of said lands and, in the event of the termination of the present lease, the said royalty shall be delivered and/or paid out of the whole of any oil, gas or other minerals produced from said land by the owner, lessee or anyone else operating thereon. TO HAVE AND TO HOLD said rights unto the said Assignees herein forever, but this Assignment is made and accepted without any warranty whatsoever, either express or implied not even for a return of the purchase price, except for acts by, through and under Assignor. This Assignment is, however, made with full substitution and subrogation in and to any and all rights or actions of warranty which Assignor may now or hereafter have or hold against any former owner. The provisions of this conveyance shall be binding upon and shall inure to the benefit of the heirs, successors or assigns of Assignor and the Assignees. WITNESS WHEREOF, this Assignment is executed this       day of       , 20       in the presence of the undersigned competent witnesses, but is effective as of the       day of       , 20       , at       A.M./P.M. . WITNESSES: _________________________________________ Representation of the Estate of       Deceased, and the Co - Trustee and Delegate of       , Co - Trustee of the Revocable Trust Agreement of       , under Amended and Restated Revocable Trust Agreement dated       , 20       , Distributee of the Estate of       , Deceased This instrument prepared by:                   Exhibit “A” attached hereto prepared by:       Indexing Instructions: This instrument should be indexed in the sectional indices of the noted Townships and Ranges. ACKNOWLEDGEMENT STATE OF       COUNTY OF       PERSONALLY appeared before me, the undersigned authority in and for the said and State, on this       day of       , 20       , within my jurisdiction, the within named       , who acknowledged that he/she is the within named Personal Representative of the Estate of       , Deceased, and the Co - Trustee and Delegate of       , Co - Trustee of the Revocable Trust Agreement of       , under Amended and Restated Revocable Trust Agreement dated       , 20       , Distributee of the Estate of       , Deceased, and that in said representative capacity he/she executed the above and foregoing instrument, after first having been duly authorized so to do. (Affix Seal) ________________________________________ Notary Public My Commission Expires: