Name: Company: Email: Address: City: State: Zip: Phone: Fax:   I seek investments in Oil & Gas: I am interested in buying these types of assets (check any) Operated Wells Purchase Amount? Less than $1 MM $1 MM - $10 MM$10 MM+ Non-Operated Wells Purchase Amount? Less than $100 M $100 M - $1 MM$1 MM+ Royalties / Minerals Purchase Amount? Less than $100 M $100 M - $1 MM$1 MM+ Prospect Purchase Amount? Less than $100 M $100 M - $1 MM$1 MM+   I seek investments in Oil & Gas: I am seeking investments in these producing regions (check any) All areas listed below West Texas North Texas East Texas Texas Panhandle Texas Gulf Coast Louisiana - Southeast SE New Mexico Rocky Mountains Pacific Region Mid Continent Region Appalachian Basin Offshore Gulf Canada / International   I seek investments in Oil & Gas: I have reviewed and understand the drilling-prospects.com Disclaimer and SEC Statement and I am the following class of investor (check any statement) A Person Involved in the Oil & Gas Business; and/or Registered Broker-Dealer or Institution Private Business Development Company Corporation, Trust or Partnership with $5MM in assets Individual with net worth or joint net worth of $1MM Individual with income in excess of $200M or joint income in excess of $300M in last two years Trust with over $5MM in assets and accredited investors An entity owned by an accredited investor     Please provide any other important information: Thank You!

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