DEMONSTRATION · NOT A REAL U.S. GOVERNMENT FORM
SECTION III · APPLICANT CERTIFICATION
I certify that the owner/payee information entered above is true and complete to the best of my present recollection. I understand that updating an email address does not, by itself, transfer a mineral interest, alter a lease, or cause a royalty decimal to become friendlier.
PRIVACY ACT-ISH NOTICE: This fictional demonstration form is not issued by any federal, state or local government. No real public benefit will be delayed because you used blue ink.