Fill and Sign the For Oil and Gas Facilities Form

SURFACE LEASE AGREEMENT(For Oil and Gas Facilities) STATE: COUNTY: LESSOR: (Name and Address) LESSEE: (Name and Address) EFFECTIVE DATE: For adequate consideration, the receipt and sufficiency of which is acknowledged, Lessor, named above, leases and lets to Lessee, named above, the following lands (the “Lands”) located in the county and state named above: (Description of Lands) For adequate consideration, this Agreement is entered into and a Surface Lease (the “Lease”) is granted by Lessor and accepted by Lessee on the following terms: 1. The term of this Lease shall extend for a period of (specify period), with Lessee ha ving the option, at the end of that period, to renew this Lease annually thereafter, from year to year, so long as Lessee makes use of the Lands for the purposes provided below, at the annual rental of $____, to be paid annually in advance as provided below. The rental date will be the ____ day of ____ each year. 2. This Lease is granted for the purpose of allowing Lessee the right to construct, operate, and maintain on the Lands a pumping and injection station, oil production facility, bui ldings, pipeline connections, tanks, offices, and fixtures necessary for that station. Lessee shall ha ve the full, free, and exclusive use of the surface of the Lands during the term of this Lease, t ogether with the right of ingress and egress to and from the Lands, and from, over, and across other la nds owned by Lessor. 3. All equipment, fixtures, and facilities placed on the Lands by Lessee, shall be and remain the property of Lessee. Upon expiration of this Lease, Lessee shall have a reasonable time, not to exceed (specify period), in which to remove all of Lessee’s equipment, fixtures, and facil ities. Following the termination of the Lease, Lessee shall restore the Lands, as nearly as practicable, to its original condition. 4. Lessor shall pay the ad valorem taxes on the Lands. Lessee shall pay all taxe s assessed against any structure, material, equipment, fixtures, and facilities placed on the Lands by Lessee. 5. Lessee shall fence and maintain the Lands. Any changes in roads or entrances to the Lands must be approved in writing by Lessor. 6. This Lease, and all of its terms and provisions shall extend to and be binding on the heirs, devisees, executors, administrators, representatives, successors and assigns of Lessor and Lessee. This Lease is executed by Lessor and Lessee as of the date of acknowledgment of t heir signatures, but shall be effective as of the Effective Date stated above. Lessor Lessor (Acknowledgments)