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Effective 11-86
Form MW·
(RevIsed 4-96)
Piling 11ee - $25.00· Non-Befundable
STATE 0' WYOMING.
BOARD OF LAM> CO~SSIONERS
OIL & GAS LEASE XNTEREST AssIGNMENT
,.,; . - ..~
'Wyomiag Oil & Gas Lease Serial Number 05 - 0 0 3 8 3 &.ígJm~tAw"roval Dale-
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A$IGNOR. with name and address at· Lane Lasr i ch· .. .~
2597 Eâst B·~idgér Blvd'~
Sandy, Utah·: 84'093
Retúm To-
Slàle Lands &: In_bnen"
122 West 2S!h Stn!et
Henchler BuildIng. 3 West
A1!'P'Að~
'dUN ! 9 m07
00 üt1y; 4:
Being the owner of 100% percent Leasehold
(Type Of Interest Leuehold/Operating Rlghts/OverridJng Royalty)
interest in this lease, described in particuJar if less than the total leasehold as:· .
Township 24 North, Rancje'118 West, 6th PM, L~ncolnCounty, Wyoming
-Section 16: All
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For good and valuable consideration, hereby assigns to: uUU"'UU.IU.AU..~..~_~.u~~~u~..".u".uu",,,,,,,u~u"'U"."'''''I''''''UI.uU''11..........UUU.lu.....u"
1) ASSIGNEE, with name and address at
100
Fi tzsinunOIj.s,· L;LC
2201 Cabin Court
Gillette,. . WY. 82718,
percent inteIe8t in the totalleasebold, or as described in ~.above.
2) ASSIGNEE, with name ønd address at
percent interest in the total Jeasehold, or as described in partlcWar above.
3) ASSIGNEE, with name ønd address at
percent Interest in the totalleaseh0J4 or as described in particu]at above.
4) ASSIGNEE, with name ønd address at
. \
vì·'--i
l (I
percent interest in the totalleasebold, or as described In particu]at above.
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5) ASSIGNEE, with name and address at
percent interest.in the total leasehold, or as described in particu]at above.
4.5% of 8/8ths overridinq royalty
ønd reserving unto ASSIGNOR:
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ThIs UlfgJuneat II I.bjed .. UI7 exbtløg 01'errIoHng royaltiea pmrloasly mand. RaUY.timia of 01'mldiD& iDtaall ..lilt be aPJ'101'ed by the
DIrector, ucI aay lach .ppro....1 II nbjed 10 the CODdItioa Ihat ovmldiD& royaJ.tieamay be cuceUed by the Board of Land CoIlUDluloaen If It
flads that nch ovenldlag IO)'8!tIea crealt a bardea oa the lease which plUmll or --lIIIb11 hltufaea wllh III denlopmeat.
ASSIGNOR certlfia by llgaature oa reverse, that ASSIGNOR II !he cnma of the latl!l'l!ilabcw~ hereIa traaafared, md ASSIGNEE(S
cmlfy(lea) by llgaiag on the lUerse that IhJa asalgmamt CODltilatu a blacUng accepliiac:e of aU the Ienaa, coDdlticma, Itlpalaticma, mlrlctioDS aad
ltatatea BovemiDg the leale deaaibed above, ucI of the Rala of the Boud. at (]qpter 6, Leasiag Of Sabndace 1leao1lll:a.
This form JIUIy be dup/ialled.
If 'f'IlŒ is needed for llddilionø/lI$$Ìgnors or 1I$$Ìgn«5 submit œpies 01 this form only.
Page
of _ of Lease H
assignment dated
State of Utah )
) ss.
County of Salt Lake )
O~Dt!O""1~·
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2O--L.
By-
Tit1e-
Karen Lasrich
Before me, the undersigned, a Notary Public, in and for said County and State, on this 27th day of March 2007 personally appeared LaneLasrich and
Karen Lasrich, his wife, to me known to be the identical persons, described in and who executed the within and foregoing instrument of writing and acknowledged
to me that they duly executed the same as their free and voluntary act and deed for the uses and purposes therein set forth.
IN WITNESS WHEREOF; I have hereunto set me hand and affixed my notarial seal the day and year last above written.
AsSIGNMENT REOUIREMENTS
Notary Public
KATHLEEN M VAN WART
8174 South 2660 East
':·,.,ndy. UT 84093
H I Commission Expires
. January 5, 2008
State of Utah
My commission expires:
6 /-óS- dB"
NotaryPubIiC7f""~Ih. ~W~
Note: AssIpm~nts Me not valid until aDlIl"OVed bv the Director. Office of State Lands and Investments IS ner State Oil &: Gás Lease
Tenus. and annnwllls solely for administrative namoses and should not be Internreted IS wamntv that IllY nartv to this ..Iponent
holds lenl or eaultable Interest In this lease. Assltmments which do not meet the reaulrements listed below and those In the Lease
and Rules will be returned unaDProVed.
t) ThIs form mut be completed Uld aubmltted for UlY uslgnment of State on &: GIS Lease leasehold interest. undivided or divided
IS to separate tracts, formatlona, zones 01' deposits. and for ovenidlng royalty interest.
2) Assignments of less than a 100"/. leasehold interest. do not reUeve th~ uslgnOl' of the obUgalions as a lessee under the tenDS of the
lease regarding the interest conveyed unless the State first has In lwad. a written apeement to be bound IS lessee for all obligations
under the lease for the assigned portion from the assignee. ThIs requirement Ihould not be construed in any way IS I release or
recision of the obUgatlons of any larety bonding parties under the requirements of the Slate oU Uld gas lease, Board Rules or this
ualgnment. (All lessees are ultimately responsible for the perfOl1lWll:e under the lease, Uld default aabjects the entlœ lease to
forfe1ture not Jut the interest related to Uly perfOI'llllllœ obUgatlon considered to be in default.)
3) A algned original and one copy of each uslgmnent mast be flied with the Wyoming State Lands Uld Investments.
4) Each 1S81gnment.1f approved. Is recognized by the Slate IS effective IS of the date of approval by the DIrector. Adequate bond mast
be famished covering any and all productive zones prior to approval of any assignment of interest in an operating State 011 and gas
lease, whether wellbores exist on the leased lands or DOt" and In no use can cIrlIIing operations, including to prospectively
productive zones under opentlng leæes, begin without. bond fin! being in place.
5) If there Is more than one party in Interest to this usl¡µunent. then all IUm parties In Interest must algn the doeument belore
IS8lgnment approval will be given.
6) The appropriate legal desalptlon of the conveyed lands interests mast be given.
7) Asslgnmenll creating a leparate (reissue) lease IUbject to the rules and regulations governing all Slate of Wyoming Oil &: GIS Lease
do not clwtge the terms and conditions of the origInaI lease, the lease annlversazy date, nor the obUgations and anniversary date of
the lease created there from being considered IS If It had been Issued on the effective date ot the original lease. (See Board Rules,
Chapter 6, Section A.)
8) CorporatIons, limited Uablllty companies, and Umlted partnerships must be qua1lfled with the Wyoming SecreIaIy of State's Office,
and general partnership papers are required to be flied with the State Lands and Investments prior to, and IS a condition of Board
approval of any ISslgnment.
9) Assignments will not be considered for approval where ISslgnor or any aB8lgnee currently has a delinquent (late) royalty or
rental payment obllgalion(s) for any State subsurface resource lease.