Membership Application Form (B0994778-2).DOC

							                                           GOLDEN TRIANGLE ENERGY, L.L.C.,
                                             a Missouri limited liability company

                                                TRANSFER NOTICE FORM

The following information is to be furnished to Golden Triangle Energy, L.L.C., a Missouri limited liability company (the
“Company”) in order for the Company to determine whether to approve (i) the proposed acquisition by the undersigned of
membership units of the Company and (ii) the admission of undersigned as a member of the Company, each pursuant to the
Company’s Unit Transfer Policy and the Company’s Amended and Restated Operating Agreement dated October 22, 2010,
as amended, supplemented and restated from time to time (the “Operating Agreement”). The undersigned buyer/transferee
and seller/transferor each acknowledge that the Company will rely upon the following information for purposes of such
determination and each hereby certifies that the following information is true and correct.

Name of proposed buyer/transferee:
                                               (print name as you would like it to appear on certificate)

Address of buyer/transferee:




                            Telephone:
                            SS# or Tax I.D. #(s):

Signature of proposed buyer/transferee:                                              Date:                         , 20___

Number of units proposed to be transferred:                Price per unit:            Total Price for all units:

Describe other materials terms of the transfer (if any):




Is buyer/transferee a current member of the Company?               Yes              No

Name of proposed seller/transferor:
                                       (print name as it appears on certificate)

Address of seller/transferor:




                            Telephone:
                            SS# or Tax I.D. #(s):

Signature of proposed seller/transferor:                                             Date:                         , 20___

Below is for use by Golden Triangle Energy, L.L.C. only

___ Transfer approved

___ Transfer NOT approved

Dated this ___ day of _______________, ______.