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000867
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Foon 3000-3
(January 1996)
UNITED STATES
DEPAR1MENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
FORM APPROVED
OMB NO. 1004-0034
Expires: September 3D, 1998
ASSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
L~ase Serial No.
WYW-172837
Lease Effective Date
(Anniversary Date)
June 1, 2006
New Serial No.
Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.)
Act for Acquired Lands of 1947 (30 U.S.C. 351-359)
Geothermal S.team Act of 1970 (30 U.S.C. 1001-1025)
Department of the InteriÓr Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508)
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
1.
Assignee"
Street
City, State, ZIP Code
EOG Resources, Inc.
P.O. Box 4362
Houston, TX 77210
"If more than one assignee, check here
attachedsheetofpape~
This record title assignment is for: (Check One) C8:I Oil and Gas Lease, or
I
Interest conveyed: (Check one or both, 8S appropriate) IZI Record Title,
! ;
o and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate
o Geothermal Lease
2. This assignment conveys the following interest:
Land Description Percent of Interest Percent of
Additional space on reverse, if needed. Do not submit documents or agreements Owned Conveyed Retained Overriding Royalty
other than this form; such documents or agreements shall only be referenced or Similar Interests
herein. I Reserved Previously
i reserved
i or conveyed
a b c d e f
Township 26 North. Ranoe 112 West. 6th P.M. 100.00% 100.00% None None None
Section 19: Lot 4(18.22)
Containing 18.22 acres, more or less
Lincoln County, Wyoming
RECEIVED 8/21/2006 at 11 :39 AM
RECEIVING # 921517
BOOK: 630 PAGE: 867
JEANNE WAGNER "
LINCOLN COUNTY CLERK, KEMMERER, WY
. - - - _. _.- - - -- -.---- -.-. - --.---- _._----- -._- - -----.--.------
-.
o Overriding Royalty, payment out of production or other similar interests
or payments
FOR BlM USE ONLY - DO NOT WRITE BELOW THIS LINE
UNITED STATES OF AMERICA
This assignment is approved solely for administrative purposes. Approval does not warrant that either party to this assignment holds legal
or equitable title to this lease.
o Assignment approved for above described lands;
Assignment approved effective
o Assignment approved for attached land description
o Assignment approved for land description indicated on
reverse of this form.
By
(Authorized Officer)
(Title) . . ___.n' (pate)
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O~)2'151?
000868
STATE OF WYOMING
)
) SS.
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Part A (Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No.1, if needed, or for Land Description in Item No.2, If
needed.
COUNTY OF LARAMIE
On this 2nd day of June, A.D. 2006, before me personally appeared MARC RANDAL SiRAHN, President of
Hanson & Strahn, Inc., to me personally known, who, being by me duly sworn, did say that he is the President of
Hanson & Strahn, Inc. and that the seal affixed to said instrument is the corporate seal of said corporation and that said
instrument was signed and sealed on behalf of said corporation by authority of its Board of Directors, and said
President acknowledged said instrument to be the free act and deed of said corporation.
Witness my hand and seal this 2nd day of June, A.D. 2006.
~1Q, ~fYw/
ta Public
COUNTY OF
LARAMIE
MY COMMISSION ~ES APR. 6. 2009
STATE OF
WYOMING
My Commission xpires:
Address: Cheyenne, Wyoming
1. 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 under
the laws of the United States or of any State or territory thereof. For the assignment of NPR-A leases, assignee is a citizen, national, or resident alien
of the United States or association 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 interest, direct or indirect, ~n 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 (1) Assignee
is not in violation of sec. 41 of the Mineral Leasing Act.
I
3. Assignee's signature to this assignment constitutes acceptance of all applicable terms, conditions, stipulàtions 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 an~lief and are ma17 in good faith.
Executed this 2nd day of June ,20 œ Executed this II day of I j~
Name of Assignor as shown on curt;.::,t lea¡eJ EOG Resources, Inc. t7
Assignor '- V 2AU Assignee
or Marc Randal Strahn, P or
Attorney-in-fact No Attest Required Attorney-in-Fact
, 2Q:)'~
æy/dA~
R. L. ADAMS
AGENT AND ATIORNEY·IN·FACT
Cheyenne
(City)
P.O. Box 3020
(Assignor's Address)
WY
(State)
82003
(Zip Code)
Public reporting burden for this form is estimated to average 30 minutes per response including the time 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, Bureau Clearance Officer, (DW-110), Denver Federal Center, Building 40, P. O. Box 25047, Denver, CO 80225-0047, and the Office of Management and
Budget, Paperwork Reduction Project (1004-0034). Washington, D.C. 20503
Title 18 U.S.C. Sec. 1001 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.
·U.S. GPO: 1992-774-017/67022
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