FORM

In order for us to make a cash offer, we will need some preliminary information from you. After receiving that information, we will contact you and make a cash offer that will be contingent upon the receipt of more detailed information (support for the details you enter into these forms).

Please fill this form out completely and hit submit and we will contact you shortly with a cash offer (or you can fax this info to 866-680-6278). If you fax the info please include the check stubs from the most recent 4-6 months if possible.

Oil Lease Buyers - SUBMISSION FORM

Name

E-mail address

Address

City

State

Zip Code

Telephone Number

I wish to be contacted by: Email Mail Phone

Please provide a summary of net income (amount you actually received) for each of the past 4 months, as well as the average net monthly amount for the last six months. This information can generally be obtained from your check stubs or tax forms.

Most recent month’s net check amount
Date of that check

1 month prior net check amount
Date of that check

2 months prior net check amount
Date of that check

3 months prior net check amount
Date of that check

Average monthly net income for the last six months

(Please provide as much of the following information as possible,
as it will help us to provide a more accurate cash offer.)

Lease Name

Location City/State

Your Decimal Interest

Operator Name

Legal Description, if available:

.

(Please note: none of these are required.
We will take all submissions on this form page.)