Oil and Gas Royalties Order Request Form

Include as much information as possible. You do not need to complete every item on the form in order to submit the form; however, the more information we receive, the better job the engineer can do evaluating your interests.

About You

 Items with * are required!
*Name:
*Email:
*Phone Number:
Mailing Address:  
City:  
State:  
Zip:  
Prefererable Contact Method:  

About Your Interest


 (Obtain this information directly from your last revenue check)
Lease Name:  
County:  
State:  
Type of Interest:  
Decimal Interest:  
More Info: