STG Affidavit - Non-development and Nonpayment of Rental Executed by Owner

AFFIDAVIT OF NONDEVELOPMENT AND NONPAYMENT

OF RENTAL EXECUTED BY OWNER

STATE OF _______________

COUNTY OF _____________

_________________________________________ being first duly sworn, deposes and says:

That ______________________________________ is the present owner of the

________________________________________________________________

________________________________________________________________

of Section ______, Township ___________, Range ______ in _____________________ County, _______________________________, which land is described in an oil and gas mining lease executed on the _______ day of ________________, ______ by _________

____________________________ as lessors, and _______________________________, as lessee, recorded in Book _____, Page _____, in the office of the (Register) (Recorder) of Deed of said county.

That since the day of said lease the property covered by said lease has not been pooled, there has been no well drilled upon said land, nor any oil or gas produced therefrom, and that none of the rentals accruing under and by virtue of the terms of said lease have been paid or tendered to affiant or said lessors, or to any bank for their credit, by the lessee, or his agents or assigns, since __________________________________ and further that the lessee and his assigns had actual notice that rentals were payable to affiant under said lease. Affiant states that he has not at any time executed any extension of said original lease, and that the same has expired.

Affiant further states that by reason of the noncompliance with the terms of said lease by lessee and his assigns, affiant hereby declares said lease forfeited and will not, by acceptance of rentals, or in any other manner, recognize the same as a valid or existing lease.