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Form 3000-3
(October 1992)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
0(10243
ASSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
FORM APPROVED
OMB NO. 1()()4..(J(J34
Expira: July 31, 1995
Lease Serial No
WYW-I72578
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 Steam Act of 1970 (30 U.S.C. 1001-1025)
Department of the Interior Appropriations Act, Fiscal Year 19~1 (42 U.S.C. 6508)
Lease Effective Date
4/1/2006
1. Aslipee*
Strftt
City, Sate, ZIP Code
Type or print plainly In Ink and sign In Ink.
PART A: ASSIGNMENT
Gary-Williams Pmduction Company
370 17'" Street, Suite 53( ()
Denver, CO 80202
*H IIIOn than one transferee, check ben ( J alld lilt the lIame(l) and addrell(es) of an additional transferees on 1ft mene of tIris r- or H a øeparaœ attaebed
sbeet of paper.
This transfer is fur: (Check one) [X] Oil and Gas Lease, or [ ] Geothermal Lease:
Interest~: (Check one or hotIt, Q3 appropriate) [X] Record Title. [ ] Overriding Royalty, payment out of produáion or other
similar intaests or payments ".
2. This assi
the CoUowinR inten:st:
Land Description
A
Percent of Interest Percent of
Overriding Royalty
Owned Cmrvc:yœ RetBined Or Simillr interests
Reserved Previously
resem:d
or
comeyecI
b c d e f
100% . 100".4 0% 0% 0%
Additional space 011 rnerse, if needed. Do not submit cIocurrtenÞ or agreenJertb other than this
form; such documents or 181 cc.u..nts sball only be referenCed herein.
WlTownshiD 22 North . RmI!C 116 West. 6& P M
1\
~on 8: ALL
~ection 9: Lots 1,2, N2, N2S2,SWSW
Section 17: Lots 1,5, NE, N2NW, SENW, NESE
Section 18: Lot I
Containing 1656.48 acres more or less
..... .. _. ... _.._ u· --
RECENED 10/26/2006 at 2:04 PM
RECEIVING # 923758
BOOK: 638 PAGE: 243
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER. WY
Lincoln County, Wyoming
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v
(G
FOR BLM USE ONLY-DO NOT WRITE BELOW nus LINE
TIlE UNITED STATES OF AMERICA
This assignment is øpproved solely for sdministndive purposes. Approval does not WIUt1II1t that either party to this assignment bolds legal or equitable title to this leøse.
[ ] Alsipment approYed for above described lands; [ ] Allipmnt appl'Uftd for attached land d......lptltn.
Alsipmeat approved effedin [ ] AsIIIp_at approved for land description Indicated OD rnene of tIdI f_
By
(Autbori2Jed Officer)
(Title)
J';-.. I
(DIde)" .'
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Part A (Continued): ADDITIONAL SPACE forNIIIIICS and addresses ofadditional assignees in Item No. I, ifneeded, or for Land Description in item NO.2 ifneeded
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000244
ACKNOWI.EDGMENT
C. .¡,
STATE OF COLORADO
--~--
COUNTY OF DENVER
The foregoing instrument was IICknowledged before me this 2ti..day of
My Commission Expires: August 7, 2006
~---_.-
ACKNOWLEDGEMENT
STATE OF COLORADO
CITY & COUNTY OF DENVER ..,r . .
. ~ da of April, 2006, by Tim Howard, VIce President
The foregoing instrument was acknowledged before me thIS Y
w;m.~ prod~..n Compmy. 1r;¡{'.hv {l:f/ þ)
~ary Pubhc My Commission Expires 08120/2008
- --"'" """lgnmentS, 811 omriding royalty may not be less 1tJm one-fourth (1/4) ofone percent of tile value ofou1put, nor peatertban so percent of tile rate oftoyalty due to tile
. United States when thinssignment ihdded to all previouSly creatM cmmding royalties (43 CPR 3241). . .. ,
I certif'y,tbat the sllllt.u.ub made herein by ~ ere true, coDtpIete. and correct to the best of my IatowIedge and belief and .. made in Fad fùh.
Executed this ?fl'
Assipor:
Or
Atto~-1II-18ct
Assignee:
Gary-Wlllla.. ProcIKtf08 Company
þ-/Z;- #
(SipoIare) - r... Røwwd - v... PreoIdoat. SpoåIII Projocb
2006
Execuœd this
,,-N-
If) day of April
2006
(SipoIure)
1645 Cow1 Place, Suite 422
(Aaipor', """'-)
Denver, CO 80202
(City) (SUIe) (Zip Code)
A.Ipee:
or
AttGney+fact
(S/pIure)
Assignee;
Attomey-i.ract
Public rqJOrting burden fur this furm is estim8ted to average 30 minutes per n:sponse including the lime fur reviewing instructions, gsdtering IIId maintaining data, and
completing and æviewing the form. Dim:t COIDIIIeIIts regarding the burden estÎIIUIœ or any other aspeçt of this form to U.S. Dt."",buatt of tile Inœrior, 8uraIu of lind Management,
(AIternaœ) Bumm Clc:annœ Offic¡er (W0-771), 1849 C Stæet, N.W., Wallington. D.C. 20240, and the Office ofMmmgement and Budget, PIperwurk Reduction Project (1004-0034),
Washington, D.C. 20503
Title 18 U.S.C. Sec. IOOIIllÛell it. crime for any person knowingly and willfully to IDIIke to any Dep..bllÇJd or agmcy of tile United States 811)' fabe, fictitious or hudulent ~
or representations lIS to any matter within its jurisdiction.
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