Page 19 - Petrospex_Elaine Prospect
P. 19
IN WITNESS WHEREOF, the undersigned has executed this Purchase Agreement
and Power of Attorney this ________ day of __________________, 2019.
______________________________________ ____________________________________
Signature of Purchaser Residence Address
______________________________________ ____________________________________
Name of Purchaser (Typed or printed) City or Town
______________________________________ ____________________________________
Signature of Co-Purchaser State Zip Code
______________________________________ ____________________________________
Name of Co-Purchaser Daytime Telephone
______________________________________
E-mail address for drilling updates
______________________________ _______% $______________________
Taxpayer Identification or %of Working Interest Purchase Price
Social Security Number(s)
STATE OF __________________
COUNTY OF ________________
THIS INSTRUMENT WAS ACKNOWLEDGED BEFORE ME ON THE ___ DAY
OF
___________________, 2019, BY ________________________________.
________________________________________
NOTARY PUBLIC IN AND FOR THE
STATE OF _________________
_____________________ ________________________________________
DATE Brook Hatchett For Petrospex,LLC
Purchase Agreement – Page 3 of 3