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STATE OF NEBRASKA <br />OIL AND GAS CONSERVATION COMMISSION <br />PO BOX 399 <br />SIDNEY, NEBRASKA 69162 -0399 <br />(308) 254 -6919 <br />Fax (308) 254 -6922 <br />www.nogcc.ne.gov <br />STATE OF NEBRASKA ) <br />ss. <br />COUNTY OF CHEYENNE ) <br />William H. Sydow,/Director <br />January 2013. <br />201300535 <br />4242 7h �-- <br />Notary Public <br />JAMES R. GOHL <br />COMMISSIONER <br />TIM WISTROM <br />COMMISSIONER <br />THOMAS M. SONNTAG <br />COMMISSIONER <br />WILLIAM H. SYDOW <br />DIRECTOR <br />A F F I D A V I T <br />Affiant, being first duly sworn upon oath, deposes and states that he <br />is the Director of the Nebraska Oil and Gas Conservation Commission, <br />and hereby certifies that, in said capacity, he has reviewed and <br />examined the records of the Nebraska Oil and Gas Conservation <br />Commission as they relate to the following- described lands: <br />T. 12 N., R. 11 W., Hall County, Nebraska <br />Section 4: All <br />Affiant further states that there has been no production on the above - <br />described lands. <br />Affiant further states that there are no approved drilling permits <br />outstanding on any part of the above - described lands. <br />Further, Affiant sayeth not. <br />Subscribed in my presence and sworn to before me this /5 day of <br />