Form E

FORME

Approved by the Secretary of the Interior March 20, 1952

OSAGE MINING LEASES

. C_O_N_T_RA_C_T_N_U_M_B_E_R

_,.J

'

EVIDENCE OF AUTHORITY OF OFFICERS TO EXECUTE PAPERS

(To be sworn to by Secretary and President of a corporation and sealed with its seal.)

I solemnly swear that and

were on the day

of 20 , the duly elected, qualified and acting president and secretary, respectively, of

a corporation organized under the laws of --,- _ on which day they executed

--------------mining lease for and in behalf of said corporation as lessee, covering certain lands of the Osage Tribe; that they were fully empowered to execute said _. lease and all papers in connection therewith, and that their action in executing the same binds the said 9orporation to full performance of all obligations thereunder.

This day of 20

(CORPORATE SEAL)

President

Secretary·

Subscribed and sworn to before me this day of ,20 .

Notary Public

My commission expires: _