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KOLAR Document ID: 1384197KANSAS CORPORATION COMMISSIONForm T1 July 2014OIL & GAS CONSERVATION DIVISIONForm must be Typed Form must be Signed All blanks must be FilledREQUEST FOR CHANGE OF OPERATOR TRANSFER OF INJECTION OR SURFACE PIT PERMIT Check Applicable Boxes: Form KSONA1, Certification of Compliance with the Kansas Surface Owner Notification Act, MUST be submitted with this form.4**Effective Date of Transfer:Gas Lease: No. of Gas Wells**KS Dept of Revenue Lease No
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