List of Corporate Officers Form

Leasing of Osage Reservation Lands for Oil and Gas Mining (25 CFR 226)

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OMB# 1076-0180 Expires XX-XXXX

Date

Superintendent Osage Agency

P. O. Box 1539 Pawhuska, OK 74056

Dear Superintendent:

The current listing of Officers and Directors of the

(Corporation), of

, is as follows:

DIRECTORS

ADDRESSES

Respectfully,

Updated March 9, 2017