Your Name

Owner of Minerals (if different)

Relation to Owner

Telephone Number

Cell Phone Number

Mailing Address

Email Address

Tell Us About the Mineral Rights >>
Please provide as much detail as possible.

County

State

Township

Range

Sections

Net Mineral Acres

Leased? (Yes/No)

Expiration Date

Comments/Questions

How Did You Hear About This Leasing Form?
(Internet, Family Member, Friend, Called Brigham's Office, etc.)