Fill and Sign the For and in Consideration of the Sum of Ten and No 100 Dollars 10 Form

- 1 - After Recording Return to: __________________________ __________________________ __________________________ __________________________ ) )))))))--------Above This Line Reserved For Official Use Only---------------- OIL, GAS AND MINERAL DEED FOR AND IN CONSIDERATION of the sum of Ten and No/ 100 Dollars ($10. 00), cash in hand paid, and other good and valuable considerations, the receipt and sufficiency of whic h are hereby acknowledged, I ________________________ , hereinafter referred to as "Grantor", does hereby grant, sell and convey, with limited warranty, unto __________________________ and ________________________ , as joint tenants with the right of survivorship, hereinafter referred to as "Grantees," whether one or more, all of Grantor’s mineral interest, including but not limited to oil, gas, carbon dioxide, and all other minerals in, on and under t hat certain property being situated in ________________________ County, ________________________ , and being more particularly described as follows, to-wit: SEE ATTACHED EXHIBIT “A” FOR DESCRIPTION By the acceptance of this deed, the Grantees hereby agree for Grantees, and Grantees heirs, successors and assigns, that the damages recoverable against Grantor for breach of the limited warranty stipulated in this Deed shall be limited solely to a ret urn of that portion of the consideration received by the Grantor whose interests have been sold, pledged, mortgaged, hypothecated or otherwise alienated in violation of said limited warranty. Grantor does further convey to the Grantees any and all income, benefits, rights and privileges that will hereafter be due to the owner of said mineral rights, includi ng but not limited to, all lease bonus, delay rentals and royalties. Grantor does further convey to the Grantee s all such rights and benefits as may be necessary or convenient to the Grantees in the explora tion, development, storage, transportation and production of said mineral rights, including, but not - 2 - limited to, the right to enter into all leases, options, deeds, assignments and other contracts covering said property, to drill wells, lay pipelines, erect derricks, build roads, install tanks, separators, heaters and refineries, and to pool and unitize interests. The aforesaid property does not constitute part of Grantors' homesteads. This conveyance covers _________________ net mineral acres. WITNESS MY SIGNATURE on this the ____ day of _________________, 20____. Grantor Type or Print Name STATE OF __________________ COUNTY OF __________________ PERSONALLY APPEARED BEFORE ME, the undersigned authority in and for said County and State, ______________________________, who acknowledged to me that he/she signed and delivered the above and foregoing instrument on the day and in the year therei n shown. GIVEN UNDER MY HAND AND OFFICIAL SEAL, this the ______ day of __________________, 20______. _____________________________ NOTARY PUBLIC MY COMMISSION EXPIRES: ______________________