EMPIRE PETROLEUM CORP

For the period ended Feb 2, 2026. Filed Feb 2, 2026.

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A notice of a major event between regular reports, such as results, a deal or a change of executives. It is often the first formal record of the news.

Feb 2, 2026 · Filed Feb 2, 2026

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EP$2.44+21.4%Stored close · as of Nov 6, 2026

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Contents

EX-99.5 · SECTION 3: SUBSCRIPTION AUTHORIZATION

SECTION 3: SUBSCRIPTION AUTHORIZATION

I acknowledge that I have received the Prospectus for this offering of Subscription Rights and I hereby exercise such Subscription Rights for the number of shares indicated above on the terms and conditions specified in the Prospectus. I hereby agree that if I fail to pay in full for the Common Stock for which I have subscribed, the Company may exercise any of the remedies provided for in the Prospectus.

Signature(s) of subscriber(s):
Print Name:	Print Name:
Telephone No.:	Telephone No.:
Date:	Date:

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