(KY, MI, MT, ND, NY, OH, PA, VA & WV)

Individual Royalty Address Change

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Name*
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Owner Number*
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Last Four of SSN / Tax ID*
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Phone Number*
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Email*
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Old Address*
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New Address*
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By submitting this form, I verify that I am the above-named person and I authorize EnerVest Operating Company to make this requested address change.

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