Michigan Department of Natural Resources
Forest, Mineral and Fire Management	
	ASSIGNMENT OF OIL AND GAS LEASES
This information is required by authority of Part 5, Section 502, Act 451, P.A. 1994, as amended.	

WHEREAS, certain oil and gas leases were made and entered into BY AND BETWEEN the State of Michigan, “Lessor,” and the individual(s), partnership(s), corporation(s) or other entities as outlined on Attachment A of this document.   

WHEREAS, the said leases and rights incident thereto, insofar as the lands herein described are concerned, are now by virtue of mesne conveyances owned by      .

NOW THEREFORE, for and in consideration of $1.00 and other good and valuable considerations, the receipt of which is hereby acknowledged, the present owner of said lease rights, hereinafter referred to as “Assignor,” hereby bargains, sells, transfers, assigns and conveys the following rights, title and interest in and to said leases, insofar as it covers the following described land, subject to the written approval of Lessor, to      , hereinafter referred to as “Assignee.”  

Rights, Title and Interest Assigned by this Document	
     	
Legal Description of Land in which Rights, Title and Interest are Assigned by this Document	
     	
	
ASSIGNMENT IS NOT VALID UNLESS ONE OF THE FOLLOWING BOXES IS CHECKED	
		
	Partial Assignment:	Lessee retains responsibility for express and implied covenants of the Lease	
		
	Full Assignment:		Lessee is released of responsibility for express and implied covenants of the Lease
		(Valid only upon written execution of Approval Section by the State of Michigan)	

Assignment of Oil and Gas Leases
Assignor:        Assignee:      
Page 2
IN WITNESS WHEREOF, the said Assignor has hereunto set his or her hand and seal this    day of      , 20  .

ASSIGNOR:      

By:			
Its:			

STATE OF      	)	
	)  §	
COUNTY OF      	)	

Before me, the undersigned, a notary public in and for said county and State on this    day of      , 20  , personally appeared       , to me personally known, who being duly sworn did say that he or she is authorized to sign on behalf of the Assignor named in the foregoing instrument and acknowledge to me that he or she executed the same as his or her free and voluntary act and deed.

     	, Notary Public	
State of 	     	County of	      	
My Commission Expires:	     	
Acting in County of	     	

ACCEPTANCE BY ASSIGNEE

     , Assignee in the above and foregoing assignment, made subject to the approval of the Department of Natural Resources, hereby accepts such assignment and agrees to fulfill all the obligations, rules and regulations of the Department of Natural Resources, so far as applicable thereto, and to furnish proper bond guaranteeing a faithful compliance with said leases and this agreement.

IN WITNESS WHEREOF, the said Assignee has hereunto set his or her hand and seal this    day of      , 20  .

ASSIGNEE:      

By:			
Its:			

Assignment of Oil and Gas Leases
Assignor:        Assignee:      
Page 3

STATE OF      	)	
	)  §	
COUNTY OF      	)	

Before me, the undersigned, a notary public in and for said county and State on this    day of      , 20  , personally appeared       , to me personally known, who being duly sworn did say that he or she is authorized to sign on behalf of the Assignee named in the foregoing instrument and acknowledge to me that he or she executed the same as his or her free and voluntary act and deed.

     	, Notary Public	
State of 	     	County of	      	
My Commission Expires:	     	
Acting in County of	     	

Approval of the assignment of these leases does not include approval of the transfer of separate written permission(s) required either by law or by the leases for surface operations.  Assignee shall secure from the appropriate agency separate written approval for the transfer of such permission(s).  Written permissions include, but are not limited to, easements and surface use permits.  Approval of an assignment by the State should not be construed as a representation that the Assignor owned any of the interests assigned. 
AAPPROVED:		, 20  		DEPARTMENT OF NATURAL RESOURCES	

	By:	STATE OF MICHIGAN	
     	, Notary Public				     	, Manager	
State of	     	County of	     		Mineral and Land Management Section
Forest, Mineral and Fire Management
Michigan Department of Natural Resources
PO Box 30452
Lansing MI 48909-7952
	
My Commission Expires:	     			
Acting in County of	     			

	Michigan Department of Natural Resources – Forest, Mineral and Fire Management

ATTACHMENT A – ASSIGNMENT OF OIL AND GAS LEASES
This information required by authority of Part 5, Section 502, Act 451, P.A. 1994, as amended.		
State Lease No.	Date of Lease	Original Lessee	Current Lessee	Liber and Page	Legal Description of Lands in which 
Rights, Title, or Interest is Assigned