Michigan Department of Natural Resource Office of Minerals Management – Uniform Production and Royalty Remittance (Continued) Page of Required under authority of Part 5, Section 502, Act 451 of 1994, as amended. (A) (B) (C) (D) (E) (F) (G) (H) (J) (L) (M) (N) (O) (P) (Q) (S) (I) (K) (R) Property Well 100% Mmbtu % of Vol Payment / Permit Prod Prod Prod Gross PSI Conv $ - Gross $ - Gross Decimal $ - State Gross Cost $ - Gross $ - Net Cash Basis Paying For $ - Net Costs Well ID # Producing Unit Name Number Type Month Year Volume Basis Factor Price Revenue Interest Royalty Code Costs Royalty Signature of Remitter: Date: $ SUMMARY OF NET CASH ROYALTY:
Michigan Department of Natural Resource – Office of Minerals Management Uniform Production and Royalty Remittance (Continued) Required under authority of Part 5, Section 502, Act 451 of 1994, as amended. Page of (A) Property Payment / Well ID # (B) Producing Unit Name (C) Well Permit Number (D) Prod Type (E) Prod Month (F) Prod Year (G) 100% Gross Volume (H) PSI Basis (I) Basis (J) Mmbtu Conv Factor (K) % of Vol Paying For (L) $ - Gross Price (M) $ - Gross Revenue (N) Decimal Interest (O) $ - State Gross Royalty (P) Cost Code (Q) $ - Gross Costs (R) $ - Net Costs (S) $ - Net Cash Royalty Signature of Remitter: Date: SUMMARY OF NET CASH ROYALTY: $
PR4227-7A_489557_7.docx