Fill and Sign the Rtp Easement from Citizen to Lpa Department for Local Form

Page 1 of 4 SUBSURFACE UNDERGROUND STORAGE CONVEYANCE This Subsurface Underground Storage Conveyance (the “Conveyance”) is dated to be effective _____ (the “Effective Date”), between _____, whose address is _____ (as “Grantor”), and _____, whose address is _____ (as “Grantee”). 1. Grant of Storage Rights: Grantor, for valuable consideration, the receipt and sufficiency of which is acknowledged, GRANTS, SELLS, CONVEYS and TRANSFERS to Grantee, all of Grantor’s rights, and the exclusive rights to inject and store non-hydrocarbon substances in and withdraw and remove those substances from the zones or formations underlying the subsurface of the lands all as described in Exhibit “A” (the “Property”). The zones and formations described in Exhibit “A” are referred to as the “Storage Reservoir.” Grantor grants to Grantee, all rights of the owner of the surface estate to and incident to the injection, storage, withdrawal, and removal of non-hydrocarbon substances, including without limitation the following: The right to use the Storage Reservoir as an Underground Storage Reservoir, to use, produce, or sell any non-hydrocarbon substances within the Storage Reservoir, and to store and remove non-hydrocarbon substances in the Storage Reservoir and retain possession and ownership of all non-hydrocarbon substances so stored, as personal property. 2. Limitations on Use of Surface of the Property: Grantee shall have no right to enter on the surface of the Property without Grantor’s consent, which consent shall not be unreasonably withheld. In the event Grantee determines, in its sole discretion, a need to make use of any part of the surface of the Property for use of subsurface underground storage, Grantor and Grantee shall enter into a mutually acceptable agreement setting out Grantee’s rights t o make use of the surface, and its obligations to compensate Grantor for the use of the surface of the Property. 3. Ad Valorem Taxes: If, and to the extent any ad valorem real property taxes are assessed against the Property, a portion of which are attributable to the rights acquired by Grant ee, or resulting from Grantee’s use of the Property, Grantee shall be responsible for the payment of those taxes. Grantee shall be responsible for payment of any personal property taxes assessed against any personal property Grantee may install on the Property. 4. Warranty of Title: Grantor hereby warrants and agrees to defend title to the Property and Storage Reservoir and should Grantor acquire any additional rights, title, or interests i n or to the Storage Reservoir or Property, it shall be subject to the terms of this Conveyance to the same extent as if owned by Grantor as of the Effective Date of this Conveyance. Grantor agree s that Grantee shall have the right at any time to redeem for the Grantor, by payment, any de ed of trust, mortgage, taxes, or other liens on the Property, in the event of default of payment by Grant or, and shall be subrogated to the rights of the holder of such deed of trust, mortgage, or lien. 5. Commingling: To the extent Grantor owns any rights, title, or interests in and to the minerals underlying the Property, Grantor expressly consents to Grantee commingling non- hydrocarbon substances with any minerals which may exist within the Storage Reservoir. Page 2 of 4 6. Binding Effect: This Conveyance shall extend to and be binding on the heirs, assigns, executors, administrators, personal representatives, and successors of the Grantor and Grantee. Either of them may assign, transfer, and convey, either in whole or in part, its ownership or interest in the Property, rights, and privileges of ownership. 7. Drilling: Drilling through the zones and horizons comprising the Storage Reservoir could adversely affect the integrity of the Storage Reservoir in the Property conveyed to Grantee and to be utilized by Grantee in its storage operations. To the extent Grantor may be a mineral owner, Grantor agrees not to drill through or into or grant others the right to drill through or into the zones and horizons comprising the Storage Reservoir, without Grantee’s written consent. Grantee will not withhold its consent unless the proposed operations could potentially damage or drain the Storage Reservoir or any proposed lease or agreement does not contain protective measures and indemnifications that in Grantee’s reasonable judgment protects Grantee and the Storage Reservoir from damage or loss. 8. Further Assurances. By this Conveyance, it is Grantee’s intent to convey and transfer to Grantee all rights attributable to the surface estate in the subsurface depths in the lands described in Exhibit “A” to this Conveyance for the purpose of storing and sequestering non- hydrocarbon substances. To give full effect to Grantor’s intent, for the consideration paid to Grantor, Grantor covenants and agrees to execute and deliver all other and further instrume nts and assurances as may be advisable or required to give full effect to Grantor’s intent. 9. Governing Law: This Conveyance, its validity, construction and all rights under it shall be governed by the laws of the State of Texas. It is executed by Grantor and Grantee as of the date of the acknowledgment of their respective signatures, but shall be effective for al l purposes as of the Effective Date stated above. Grantor Grantee (Acknowledgments) Exhibit “A”: Description of Property and Storage Reservoir Depths. Page 3 of 4 EXHIBIT “A” TO SUBSURFACE UNDERGROUND STORAGE CONVEYANCE DESCRIPTION OF PROPERTY Page 4 of 4 EXHIBIT “B” TO SUBSURFACE UNDERGROUND STORAGE CONVEYANCE MEMORANDUM OF SUBSURFACE UNDERGROUND STORAGE CONVEYANCE STATE: COUNTY: GRANTOR: GRANTEE: EFFECTIVE DATE: (Effective date of the Agreement) For adequate consideration, Lessor, named above, has granted, leased, and let to Lessee, named above, for the purposes of injecting, storing, sequestering, and withdrawing non- hydrocarbon substances, including carbon dioxide (the “Substances”), the following lands (the “Lands”) in _____ County, _____: (Description of Lands covered by the Conveyance) The Conveyance is for an Initial Term of _____ (_____) years from the Effective Date stated above, with Lessee having the option to extend the term of the Agreement, a nd to acquire an oil and gas lease on the Lands, and is effective as long thereafter as Lessee i s injecting, storing, or withdrawing Substances on or from the Lands or other lands unitized with the Lands, according to and by the terms and provisions of the Conveyance between Lessor and Lessee. The Conveyance, with all of its terms, covenants, and other provisions, is referred to and incorporated into this Memorandum for all purposes. This Memorandum is placed of record for the purpose of giving notice of the Subsurface Underground Storage Conveyance between Lessor and Lessee, and the Lands it covers. The original of the Subsurface Underground Storage Conveyance is maintained in the office of the Lessee. This Memorandum is executed by Lessor and Lessee as of the date of acknowledgment of their respective signatures, but is effective for all purposes as of the Effective Dat e stated above. Lessor Lessee (Acknowledgments)