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REPORT OF PROPERTYMELL TRANSFER OR ACQUISITION <br /> (To be completed by old and new operators) <br /> Please complete and return this form to: [ i h —gam o)�a r— �—2004 <br /> 1 (dat_ef ' <br /> Division of Oil,Gas,and Geothermal Resources <br /> 801 K Street. MS 20-22 <br /> Sarraneurn . f A 95$jG— X53 <br /> Effective date o1 transfer/aogc>m*w O r t n h e r 1, 2 0 0 4 date of Possessi0►0 r t n h e r 1 2004 <br /> (dol,.) (it diff-* t) <br /> Tri—Union Development Corporation transferred <br /> (OW op"O" <br /> the"owing wells to TO-C-1 F u e r n y (G PT) ]„1 r <br /> NOTE: Pursuant b Section 3202 of the Public Resources Code, before wells will be transferred, the new operator must provide <br /> proper bond coverage and wee irillonrabon for all transferred active,idle.andlor plugged and abandoned wells. <br /> Wel Designation Field or County Sec. T. R. API Number <br /> All WP I-q <br /> (M additional space is needed,use separate sheets.) <br /> Legal desc npbon of the lard where the well(s)is(are)located: <br /> OLD OPERATOR NEW OPERATOR <br /> Tri-Union Development Corp Tezrall- Ener <br /> (o nnewe earn) ( 1 <br /> 801 Trayis—Ste 2102 801 Travis , Ste 2102 <br /> (ad*-V (add--) <br /> Hntistnn- TX 77002 <br /> Phone <br /> BY LL 0 C ( 0 e Z L OC,i 0 <br /> ( (dare) (a(gnat ) (date) <br /> Jeffrey T Janik VP Oneratinns Jeffrey T .ianik VP—COO <br /> &W~—) aft) ' Oykftdname) 044) <br /> Note: By signing this form both the old operator and the new operator certify that the new operator owns the mineral <br /> k*wost. holds a valid and effective lease, or holds a valid and effective operating contract giving the new operator the <br /> right to operato mo well or wells being transferred. <br /> OG30A (10/03/UCP/1M) <br />