Windsor/Colesville Group Oil and Gas Lease Pool
Please complete this form and return it to either:
Jim Worden Glenn Winsor
1529 NYS Rte 79 or 2906 NYS Rte 79
Windsor, NY 13865 Harpursville, NY 13787
I have requested that the Windsor/Colesville group negotiate oil and gas lease agreement for my acreage listed below. The goals are to maximize up front payment and royalty while securing terms to protect the land. This pooling, negotiation, and the resulting lease offer are not binding nor are they to be viewed as legal advice.
Property Location: Colesville Windsor Other ________________
Description (The parcel or map number is located on your property tax bill and must be correct. For purpose of ownership, please enter "Residence", "Farm", "Recreation", "Investment", or other appropriate terms.)
Parcel or Map # Acres Purpose of Ownership
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Total Acres: _________
The oil and gas rights for the property listed above are not currently under lease.
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Printed Name Signature Date
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Street Address
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City State Zip Code
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Area Code & Phone Number E-mail (Please see note below)
PLEASE NOTE: To minimize communications costs, email and the Village of Windsor web page will be utilized to communicate with group members. An email will be sent to each group member providing an email address when new information is posted to the website.
Please provide your input and recommendations (use back of sheet if more room is required):
- What are your goals for a lease and for participating in this group? What do you want out of this?
•2. What are the terms or addendums that are important for you to have included in this lease?
