LAND OFFICE REQUEST FOR FIELD ASSIGNMENT DATE TO FIELD DIVISION; 5 /Ce 04 FIELD DIVISION CONTROL NO. - REQUESTING DIVISION SUf.10.042 BY: Tar Lerne /noes 0:5 II • LEASE NUMBER: Gm - 7 9/ TYPE OF REQUEST: NAME OF LESSEE/APPLICANT: 7orrei -77-115-/ ADDRESS qo 3 e PPreti E <. Fe,s-bew ,