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UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
FORM APPROVED
OMB NO, 1004-0034
Expires: July 31, 1995
Lease Serial No
OOf
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"ÅSSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
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H:; ~J' (,I i.)
See Exhibit "A"
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,h ,'" Mineral Leasing Act of1920 (30 U.S.c. 181 et seq.)
hE eE.'l VEO Act for Acquired Lands of 1947 (30 V.S.C. 351-359)
CHEYENNE W' .... Geothennal Steam Act of1970 (30 V.S.C. 1001-1025)
(O~~ment of the Interior Appropriations Act, Fiscal Year 1981 (42 V.S.c. 6508)
Lease Effective Date
See Exhibit "A"
Type or print plainly In Ink and sign In ink,
PART A: ASSIGNMENT
1. Assignee*
Street
City, State, ZIP Code
Condor Exploration, LLC
7538 S. Salida Court
Aurora, CO 80016
*If more than one transferee, check here [ ] and list the name(s) and addressees) of all additional transferees on the reverse of this form or on a separate attached
sheet of paper.
This transter is for: (Check one) [X] Oil and Gas Lease, or [ ] Geothermal Lease
Interest conveyed: (Check one or both, as appropriate) [X] Record Title. [ ] Overriding Royalty, payment out of production or other
similar interests or payments
2. This assie:nment convevs the following interest:
Land Description Percent of Interest Percent of
Additional space on reverse, if needed. Do not submit documents or agreements other than this Overriding Royalty
Owned Conveyed Retained Or Similar interests
form; such documents or agreements shall only be referenced herein, Reserved Previously
reserved
or
conveyed
A b c d e f
SEE EXHIBIT "A" 100% 100% 0% ,5000025% 0%
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BOOK':JlOC, PRPAGE é.._
--.---.--.. -~---
HECEIVED
LI r\JCOLN COUNTY CLERJ.<
87l}330 01 Jt~L .~ f't'7 ''). 30
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JEtT ",.. '.,:1 :,()NER
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(Erv1MEnEn. ",' JMiNG
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FOR BLM USE ONLY --DO NOT WRITE BELOW THIS LINE
THE UNITED STATES OF AMERICA fOR ASSIGNEE
This assignment is approved solely for administrative purposes. Approval does not warrant either party to this assignment holds legal or equitable title to this lease.
[ ] Assignment approved for above d';s'crilièd 1íindì; Assignment approved for attaehed land description
Assignment approved effective';/) :., [ ] Assignment approved for land description indicated on reverse of this form
Gí"1ÜMn!låf!\¡ ;~, Q,t»WI LAND LAW eXAMINER
By
(Authorized Officer)
(Title)
(Date)
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Part A (Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No. I, if needed, or for Land Description in item NO.2 if needed
ACKNOWLEDGMENT
STATE OF COLORADO
COUNTY OF DENVER
OS74:j30
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The foregoing instrument was acknowledged before me this 14th day ofJuly, 2000, by oseph W. Thames, President of Baseline Minerals, In~.
My Commission Expires:
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PART B: CERTIFICATION AND REQUEST FOR APPROVAL
I, The Assignor certifies as owner of an interest in the above-designated lease that he/she hereby assigns to the above assignee(s) the rights specified above,
2, Assignee certifies as follows: (a) Assignee is a citizen of the United States; an association of such citizens; a municipality; or a corporation organized underthe laws of the United States
or of any State or territory thereof For the assignment ofNPR-A leases, assignee is a citizen, national, or resident alien of the United States or associations of such citizens, nationals,
resident aliens or private, public or municipal corporations; (b) Assignee is not considered a minor under the laws of the State in which the lands covered by this assignment are located;
(c) Assignee's chargeable interests, direct and indirect, in each public domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases (of which
up to 200,000 acres may be in oil and gas options), or 300,000 acres in leases in each leasing District in Alaska of which up to 200,000 acres may be in options, if this is an oil and gas
lease issued in accordance with the Mineral Leasing Act of 1920, or 51,200 ,acres in anyone State if this is a geothermal lease; (d) All parties holding an interest in the assignment are
otherwise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in compliance with reclamation requirements for all Federal oil and
gas lease holdings as required by sec, 17 {g) of the Mineral leasing Act: and (f) Assignee is not in violation ofsec, 41 of the Mineral Leasing Act.
3, Assignee's signature to this assignment constitutes acceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease described herein,
For geothermal assignments, an overriding royalty may not be less than one-fourth (1/4) of one percent of the value of output, nor greater than 50 percent of the rate of royalty due to the
United States when this assignment is added to all previously created overriding royalties (43 CFR 3241),
I certify, that the statements made herein by me are true, complete, and correct to the best of my knowledge and belief and are made in good faith,
,4--\h-. day of J\OCb"S'"
Executed this
Assignee:
14th
2000
Executed this
Name of Assignor as shO\~
Assignee:
Assignor:
Or
Attorney-In-fact
Assignee:
or
Attorney-in-fact
(City)
(Signature)
ce, Suite 422
(Assignor's Address)
Denver, CO 80202
(State) (Zip Code)
Attorney-in-fact
2000
(Signature)
Public reporting burden for this form is estimated to average 30 minutes per response including the lime for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land Management,
(Alternate) Bureau Clearance Officer (WO-77I), 1849 C Street, N,W" Washington, D,C. 20240, and the Office of Management and Budget, Paperwork Reductlon Project (1004-0034),
Washington, D,C, 20503
Title 18 U.S,C, Sec, \001 makes it a crime for any person knowingly and willfully to make to any Department or agency of the United States any false, fictitious or fraudulent statements
or representations as to any matter within its jurisdiction,
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