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HomeMy WebLinkAbout929340 Form3000-3 '. .i-ii\1 ii\\Jh UNITED STATES .(f«þn~Ì"Y.')p02)\\\, !,I,..:.-,;' .,< ,in';'Î" \\I~I "".'~' 1.\fhL\.¡t.¡¡..· DEPARTMENT OF THE INTERIOR '¿ú;rë M.\ ut l!\H\.I\ " BUREAU OF LAND MANAGEMENT '1,-\',-\'11 ú~\D -5 M\ g~ \A§SIGNMENT OF RECORD TITLE INTEREST IN A ¡.,.. ru' \\ LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES . ..... , -, . " '·'T'\f r.:.. U\\.IG Mineral Leasing Act of 1920 (30 U,S,C. 181 et seq,) -v.·~q\[ ~/'(m-,¡ \' Act for Acquired Lands of 1947 (30U.S.C 351-359) C r\ L \ t. \ \ \' .' Geothermal Steam Act of 1970 (30 U.S,c. 1001 -1025) Department ofthe Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508) -VVCUJ FOAAi APPROVED OMB NO. 1004- 0034 Expires: October 31, 2004 Lease Serial No. WYW-150504 Lease Eftèctive Date (Anniversary Date) 05/0112000 New Serial No. Type or print plainly in ink and sign in ink. PART A: ASSIGNMENT 1. Assignee* Zeneco, Inc. (formerly known as RZ. Inc.) Street 6100 South Yale Avenue, Suite 1700 C' . State, Z' Code rty I ! Tulsa. Oklahoma 74136 * If more 11m one &'iSigœe, dlèCk here D WId Ii.<;t the nalllè(s) IUId address( ~) of all addtiollaI assignees 00 page 2 of this tònn or 00 a separate at1ached shœt of paper. This record title assignment is for: (Check one) [2] OillUld Ga<; Lea<õe, or DGeothenllal Lease JntëreSt conveyed: (Check one 01' both as appropriate) [(] Record TItle, 0 Overriding Royalty, paymð1Ì out of production or other sinúlar interests or payments 2. 11m assignment conveys the tòllowing interest Land Description Percent ofInterest Percent of Additional space on pag.: 3, if n.:ed.:d. Do not submit docum.:nls or agreem.:nts Owned Cœveyoo Retained O~en:idÎl~ Royalty oth.:r than this fonn; such docmn.:nls or agreem.:nts shall only b.: referenced herein. SImilar nterests ReservIXl Previously resaved or conveyed a b c d e f ASSIGNOR(s) Condor Exploration, LLC .5% .5% 0% dIfference Of Record 7720 East Bellevlew, Suit. #B-l02 between Greeenwood Village, CO 80111 existing burdens Nevada Petrolem Corporation .4% .4% 0% and 20%, Of Rerol'd 1345 NW Wall Street, Suit. 100 thus, Bend, OR 97701 delivering an 800/0 Horsetrap Partners, LLC .5% .5% 0% Net Of Recol'd 2371 Brighton CI.-cle Revenue M.dford, OR 97504 Interest. W2 Sec 17-22N-114W. Uncoln County, Wyoming SUB.JECT TO THAT CERTAIN FARMOUT AGREEMENT DATED AUGUST 29, 2005 BY AND BEllVEEN ASSIGNOR'S AND ASSIGNEE. FOR BLM USE ONLY - DO NOT WRITE BELOW THIS LINE UNITED STATES OF AMERICA Thi·s assignment is approved solely for administrative purposes. Approval does not warrant that either party to this assignment holds legal or equitable titl{f{his lease. r Assigmnent approved for above dAPftÕ 1 2007 0 Assignment approvoo for attached land description Assignment approved effective D Assigmnent approved for land description indicated on reverse ofthis form By ISI Kelly Aobérts (Authorized Officer) ---.LAND LAW EXAMINER (Title) APR 2 6 2007 (Date) (Continued on page 2) RECEIVED 5/14/2007 at 1 :37 PM RECEIVING # 929340 BOOK: 657 PAGE: 839 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY FOR ASSIGMEE · 'VI~-'-I'UI-" 'J r:{ J. _~ - . . - O!-\Q Í'~~~5' , (I) {'I Part A (Continued): ADDITIONAL SPACE for names and addresses of additional assignees in Item 1~::~~~'2'-~' ~ ~ Z ro ~( ~ ., ALYCE M LARSEN z g ~ ~ ASSIGNOR /' / NOTARY PUBLIC-OREGON ..J LIJ ~ ~ I/) .' COMMISSION NO. 364338 ~ ~ o. ;. STATE OF OREGON I) ..0 .!~! 9!)MI015~,I(~1N..t'!:PJ!8S.~AN. 2~2Q07 ..,.J (J) < S:2 ~ ~ \SÞ~~~~=:Z.£:.:l) -I-I....J en COUNTY OF DESCHUTES ~ :E []) ð llJ The foregoing instrument was acknowledg ~ ~ ~ i.i5 ~ 2006, by Pahick lH Gislel', Manager of C ~ ~ fi: ~ ~ lHy commission Expires: IJ ¡'~s..()1. , NotaJ'Y Public <t: ~ ~ ð 0000 zO UJ :1! ::: o ü >- ::: STATE OF OREGON COUNTY OF DESCHUTES The foregoing insh"Ument was acknowledged 2006, by Pahick M Gisler, Agent of Nevad My commission Expires: ¡¡'3$-()'! ' ~daYOf/¢ ration. , Notary Publi By: :;R~ PLIERS, LLC ~ F1ù1~dersch,~lanager Dated: .l. - '1... \ ~. Q "':). STA TE OF OREGON COUNTY OF JACKSON The f~regoing insh"Ument was acknowledged befOl'e me tlùs Æ day of FG~(}\t\ "") 200ítby F1ù1 ~dersch, Mana. gel' of Horse~ Partners, LLC. IHy commission Expires: J 21·Vr , ~~ tJ~ ,Notary Public PART B - CERTIFICATION AND REQUEST FOR APPROVAL 1. The Assignor certifies as owner if an interest in the above designated lease that hc/she hereby assign., 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 OIganized under the laws of the United States or of any State or temtory thereof. For the ..,sigmnent ofNPR-A leases, assignee is acitizell, national, or resident alien of the UlÙted States or association of such cilizens, nationals, resident aliens or private, public or municipal corporations, (b) Assignee is not considered a minor under the laws of the Stale in wmch the lands covered by this assignrnenlare localed; (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 wlúch up to 200,000 acres may be in oil and gas options), or 300,000 acres in leases in each leasing District in Alaska ofwmch up to 200,000 acres may be in options, iftms is an oil and gas lease issued in accordance with the Mineral Leasing Act of 1920, or 51,200 acres in any one Slate iftms is a geothennallease; (d) All parties holding an interest in the assignment are otherwise in compliance with the regulalions (43 CFR Group 3100 or 3200) and the authorizing Acls; (e) Assignee is in compliance with reclamalion requirements for all Federal oil and gas lease holdings as required by sec. 17 (g) of the Mineral Leasing Act; and CO Assignee is not in violation of sec. 41 of the Mineral Lensing Act. 3. Assignee's signalure 10 tms assignment constilutes acceptance of all applicable lerms, conditions, stipulations and reslrictions pertaining to the lease described here in. For geothennal assignments, an ovemding 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 tms assignment is added to all previously created ovemding royalties (43 CFR 3241). I certify thai the statements made herein by me are true, complete, and correct to the best of my knowledge and belief and are made in600d faith. Executed tJús day of 20 Executed this ~ day of ~1 20 f1.¡L Name of Assignor as shown on cUlTent lease SEE ABOVE 'Preildent (Please type or print) Assignor or Attorney-in-fact Assignee 01' Attorney-in-fact (SÎlmalure) (Signature) SEE PAGE 1 (Assignor's Address) SEEPAGE 1 (City) (State) (Zip Code) Public reporting burden for tms fonn is estimated to avemge 30 minules per response including the time for reviewing inshllctions, gathering and maintaining data. and completing and reviewing the fonn. Direct comments regarding the burden estimate or any other aspect oftms fonn to U.S. Departmenlofthe htterior, Bureau of Land Management (1 004-0034), Bw-eau Infonnation Collection Clearance Officer, (WO-ó30), Mail Stop 401 LS, 1849 C Street, N. W., Wasmngton, D.C. 20240. Tille 18 U.S.C. Sec.l00l·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 mailer witlún its jwisdiction. (Con/timed on page 3) (Form 3000-3, page 2) '~4" ,. c: z~~ 00.. ø........ ZW<o:z ~ a: (') <- wo .: en . 0::::1 (J)..JoZ-- ~O::ïz~ 2Z~º;: It c( a. (I) "" O>>-",>i? a:a:~~ <..,,:¡e t-""":i! °OS ZO,.. ....... :2 '. ..' - ··"S3:i{¡~ PART C- GENERAL INSTRUCTIONS 000841 I. AssignoríAssignee must complete Parts A I and A2 and Part B. All parties to assignment must sign as follows: The assignor{.) muslmanuaUy sign 3 original copies and dte assignee(s) must manuaUy sign all~st ] of lite 3 original copies. File three (3) completed copies of this fonn in the proper BLM office for each assignment of I'CCIXd tide. For a transfer of oveniding royally interest, payment out of productionor other similar interest or payment, file one (I) manually signed copy of Uris fonn. The requiredfilingfee (nonr"fundable)mustaccompanyllte assignment.File assignment witIún wnely (90) day. after date of execution of assignor. 2. Separate fonn must be w;ed for each lease being affected by this assigmnent and for each type of interest conveyed. 3. In Item No.2 of Part A, describe lands affected (S"" 43 CFR 3106, 3135 or 3241). For column b. c, d, and e, enter the interest expressed as a peruentage ofrotal interestin lite lease; e.g., if assignor assigns one l \L1Iter of a 20% in- terest, enter 2O'!-oin column b, 5%in columnc. and 15~¡,in colwnn d. 4. If assignment is to more than one assignee, enter each a.'lSignee's name across The Paperwork Reduction Act of 1995 requiœs us to infonu you that: I. This irúonnation is being collected lUlSUalJt to the law. 2. This information will be used to create and maintain a record of oil and gaslgeothcnnal lease activity. 3. Response to this request is required to obtain benefit. BLJl..I would Jil¡e you to know that you do not have 10 respond to this Of any other Federal agency sponsored infonnation collection unless it displays a currently valid OMBconlrolnwnber. NOTICE The PrWacy Act of 1974and the regulation in 43 CFR 2.48(d)pro"idethat you be 1ùnúshedthe foUowinginfunnationin cOlUlection",ilh irúonnation required by tlús oil and gaslgeothennallease record title assignment application. AUTHORITY: 30U.S.C.181 etseq.; 30 U.S.C.lOOI-1025; 42 US.C. 6508 PRINCIPAL PURPOSE: The information is to be used to process record lille as- signrnenlsfor oil and gas/geothcnnal resources leases. 2. This assignment COIlVevs dIe following interest (oontitnred): 5. If any payment oul of production or similar interests, arrangements or payments have previously been created out of Ihe interest being assigned,or if any such paymenls oc interestsare resen.-ed mder this 898ÎI!J1ßIeØ, include a statement giving full delails as to amounI, method of JD)meß, uI otherpetlinent II:nns as pm\IÎded under 43 CFR 3106, 3135, or 3:!4 L 6. 1he lease account must be in good standing before this assignment can be ap- proved aspro"ided wlIlcr43 CFR 3 106 and 3241. 7. Assigmnent, if appmved, lakes effect œ lhe tin;t day rA" lhe mœllt following the dale offiling in Ihe pmper BIM office. If a bond is necessary, il must be fur. nished prior 10 approval ofthe assignment. 8. AppmvaJ of assignmcntof I'CCIXd title to 100% of a portion of lite leased lands crealessepamte leasesrA"the retaincdandthe assigncdpodions, 1U does rn ~ the tenns and condilionsof the lease amúversary date forpwposes of p8}ment of annualrental. 9. Ovemdingroyally. paymcntout rA"producûon or othersimilartypesoftransfcrs must be filed with BLM, but \\ill be acccpIed for record purposes only. No offi- cial approval will be given. ROUTINE USES: (1) The adjudicationoflhe a.~signee'srighls to the land or resources. (2) lÀx:Ima1Ia1Íœfurpublicintàmation in stwœt ofnolationsmadc at land sla1us, records forthe management, disposal, and use of public lands and resources. (3) Transfer to appropòale Federal agencies when concurrenceis reqtBred lior to granting a right in public lands or resources. (4) (5)Infonnationfian the recordandiorthc record will be tmnsfem:d to awrovri- ale Federal, Slate, local or fureign agencies, \\D:n relC\'8IIt to ci"iI, criminal or n:gqa- tory investigaûonsorprosecutions. EFFECT OF NaI' PROVmINGlNFORMATlON- If all requested informa- tion Is not provided, the assignment may not be approved. Set> regulations at 43 CFR Groups 3100 and 3200. Land Description Percent of Interest Percent of Additional space on page 3, if needed. Do not submit documents or agreements Ü\\lled Ca1V6}OO RetaÎnèd OvelTidin~ Royalty other than this fOIDI; such documents or agreements shall only be œferenced herein. Sinùlar nterests Reservèd Previoosly reselVtxl or conveyed a b c d e f (Fonn 30fJ0.3, page 3)