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Home My WebLink About926412 /1; Fonn 3000-3 (January 1996) UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT (Jt"u~(S FORM A~PROVED OMB NO.1 004-0034 Expires: September 30, 1998 ASSIGNMENT OF RECORD TITLE INTEREST IN A LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES Lease Serial No. WYW-173633 Lease Effective Date (Anniversary Date) December 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 Steam Act of 1970 (30 U.S.C. 1001-1025) Department of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508) I!J C/7 y,/ ~ -æV 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 0 and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate attached sheet of paper. This record title assignment is for: (Check One) 181 Oil and Gas lease, or Interest conveyed: (Check one or both, as appropriate) 181 Record Title, o Geothermal lease 2. This assianment conveys the follow/na interest: land DescriDtion I 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. Reserved Previously reserved or conveyed a b c d e f Township 26 North. Ranoe 113 West. 6th P.M. 100.00% 100.00% None None None Section 34: Lots 1 (29.47),2(26.73),3(27.28), NE1/4NE1/4, S1/2N1/2, S1/2 Section 35: All Containing 1,243.48 acres, more or less Lincoln County, Wyoming RECEIVED 1/3012007 at 11: 19 AM RECEIVING # 926412 BOOK: 647 PAGE: 578 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) (Date) ".,: '..', ",j Part A (Con 000579 ): A D IONAL SPACE for Names and addresses of additional assignees in Item No.1, if needed, or for land Description in Item No.2, If needed. STATE OF WYOMING SS. COUNTY OF LARAMIE On this 2nd day of December, A.D, 2006, before me personally appeared MARC RANDAL STRAHN, 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 December, A. D. 2006. STATE OF WYOMING ;\~ (' 0 Q¡ cv, ~ ~ I /~A -'0 /. 0 V\. '" \X- ~ot ry Public NOTARY PUBLIC My Commission Expires: 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, 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 of sec. 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). Assignor or Attorney-in-fact 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. I '7Ja. ~~il Executed this 2nd day of December ,20 06 Executed this ItPrlf day of - .. E.lJ.'~ / ,20 0 7 EOG Resour~".,", _/ ~ Assignee ~ orR. . Adams,. Agent .andAttorney-in-I!act Attorney-in-Fact Cheyenne (City) P.O. Box 3020 (Assignor's Address) WV (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 ,; .. . .~