Fill and Sign the Oil and Gas Lease No Texas General Land Office Form

CONVEYANCE OF RIGHT TO MAKE FREE USE OF GAS(Provided for in an Oil and Gas Lease) State: County: Mineral Owner: (Name and Address) Surface Owner: (Name and Address) Effective Date: Mineral Owner, named above, is the owner of all or a part of the mineral estate, and is the Lessor in the Oil and Gas Lease granted to _____, as Lessee, dated _____, recorded in Volume _____, Page _____, of the _____ Records of the county and state named above (the “Lease”), which Lease covers the following lands (the “Lands”): (Description of Lands subject to Lease) Surface Owner, named above, is the owner of the surface of the Lands subject to the Lease. Paragraph _____ of the Lease grants to mineral owner (or, in paragraph ____ of the Lease, mineral owner reserves) the right to make free use of gas produced from wells locate d on the Lands during the term of the Lease. For adequate consideration, Mineral Owner grants and conveys to Surface Owner the rights (reserved/granted) in the Lease to make free use of gas produced from wells located on the Lands. This Conveyance is made by Mineral Owner and accepted by Surface Owner subject to the terms of the Lease, and all restrictions it imposes on the free use of gas, and shall be for a term of the duration of the Lease, and no longer, after which this grant and transfer shall terminate and be of no further force and effect. As part of the consideration for this Conveyance, Surface Owner agrees to and shall indemnify and hold Mineral Owner harmless from any and all claims, damages, and/or injury, of any nature or kind, arising from or attributable to Surface Owners use of gas from the Lease. This Conveyance is executed by mineral Owner and Surface Owner as of the date of the acknowledgment of their signatures below, but shall be deemed effective as of the Effe ctive Date stated above. Mineral Owner Surface Owner (acknowledgments)