Get the free FORM APPROVED OMB No. 1004-0136 Expires January 31, 2004

API Well No: 43013340320000 FORM 9 STATE OF UTAH DEPARTMENT OF NATURAL RESOURCES 5.LEASE DESIGNATION AND SERIAL NUMBER: DIVISION OF OIL, GAS, AND MINING UTU-74869 6. IF INDIAN, ALLOTTED OR TRIBE NAME:

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Form approved OMB no refers to the form that has been approved by the Office of Management and Budget (OMB) for use by a specific agency or organization.

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