Lease Offer Form

Company Name (Potential Lessee)

Address of Potential Lessee

If accepted, lease will be mailed to the above address unless another address is noted here

Company Contact/Agent

Phone

E-mail

State

County

Section

Twp

Range

Legal

Net Mineral Acres

Gross Mineral Acres

Term of Lease (years)

Royalty Rate

Bonus Consideration (per net mineral acre)

Please note: AgriBank reserves the right to reject any or all offers.

If you have any questions, contact: Julia Johnson, 651-282-8419, Julia.Johnson@AgriBank.com