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Stale Lands " InwslDtenls
122· Weit2Sth Street
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WIt·! 9 1007
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Effectiye 11-86
Form ML-2
(RevIsed 4-96)
FlUng Fee· $25.00· Non-Befundable
. 51 ~. ~ ~,. ,VYOlY.lIÌl/G
BOARD OF LAND COMMISSIONERS
OIL & GASLEASE·~NTEREST AsSIGNMENT
...: .... . ,.~
Wyoming 00 " Gø Leue Serial Number 0 5 - 0 0 38 2 &síg~ent ~"'Ìroval Dale".
ASSIGNOR. with name and address at:· Lane Lasrich' ..;
2597 East B·~.idgèr Blvd-.
Sa.ndy, Utah·' 8.4'093
Being the owner of 100% percent Leasehold
(fype óflnteJal: LeuehoId/OperaUng RlghIs/OverrIding 1Ioyalty)
interest in this 1ease,described in particular if less that\_the total leasehold as:· _
ToWnship 24·North, Range 117 West, 6th PM, Lincoln County, Wyoming
·Tract· 71 (formerly W~ Section 10 )____.______
For good. and valuable consideration, hereby assigns to: ...u.UI.u."U"U~U""'~A"'~".L~~~II~~A""'I"'IUUUU·~.u"'U"":IUIIUUUUI
Fi tz.simmons ,. L;LC
2201 Cabin Court
Gillette,. . WY· 82718,
percent interest In the total leasehold. or as described in parlicWar.above.
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1) ASSIGNEE, with name and address at
100
2) ASSIGNHB, with name and addrêss at:
percent Interest in the total leasehold, or as described In particular above.
3) ASSIGNHB,.with name and addrêss at:
percent Interest In the total leasehold. or as described Inp.articulat above.
4) ASSIGNEE,. with name and addrêss at:
~
l"
/~j
percent Interest In the total leasehold, or 88 described In particular above.
\ U 5) ASSIGNEE,. with name and address at:
percent Interest In the total leasehold, or 88 descn'bed In particular above.
and reserving unto ASSIGNOR:
4.5% of 8/Rths overridinq -royalty
ThIs uslgmaent Is nbject III any exlsliDg OYmIdfug royallle. predoasly raenred. Raervallmis of o-mrldiDg iDtuull mat be approved by the
DIrector, Uld UI)' .vda appIVYalls .abject 10 the condillon lhat oyemdlug royallla my be UDCdIed by the Board óf Laud ColllDlisalouen If it
find. that neb OYaridiDg royaIlia crute a burden on the leue whleb ¡nuenls or _asoaably ÜIIeIf_ with III denlopmenL
ASSIGNOR certifla by .lpalure on reveIIe, that ASSIGNOR Is the owner of the iJltereilt abov~ herein transfared,.1Dd ASSIGNEE(S)
cerlify(iea) by aJgnIng on the ft!veIIe lhat this asaJgnment conslltalel a binding accepliinc:e of all the tenD-. condill.ODI, IlIpakllODl, rellrlclloDS Uld
.tatatn gOYmUng the lease daaibed above, IDd óf the RaIea of the Board, at Caapler 6, Leasing 01 Sabnrface Reaourca.
This fórm may be dupliCllred.
1/ spilœ is needed for IIdditiomd II$$ignOTS or IIssignus submit copies of this fórm only.
PAge
of _ ofLeøse #
Assignment dAted
SIGNED AS TO
nJ'\{7¡O~7
qJ"I.)I -., "
20~
By-
Title-
Karen Lasrich
State of Utah )
) ss.
County of Salt Lake )
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.
My commission expires:
O)-{)5~08
Notary Publicq( ~ fh. /Jd.... ¿¡)p¡;t;-
AssIGNMENT REOUIlI.EM1!NTS
Note: AAlpmenlll are not valid until aDJ'I'O"ed by the Director. Offiœ of State Landi and Invatments a Del" State 011 II: Gås Lease
Terms. and aDf'lV'/alls solely for aclmlnftstratlve DUl'DOIIa and should not be Inlemmed a wuranty that mv JWtv to this aulmment
holels Ien) 01' eaultab)e Interest In this lease. Aalmments which do not meet the reaulrements listed below and those In the Lease
and Rulee will be returned anaDDnWed.
1) 'I1ds form must be I.'Ompleled and aubmltted for any wlgnment of Stale on IE Gu Leue leasehold Interest. undivided or dlylded
u to separate tracts" lonnadona. zones or deposits, and forovenidlng royalty Interest.
2) Aulgnments of leu than a 100"1. leasehold Interest. do not relieve the wlpor of the obUgatloaa u a li!uee under the terms of the
1_ regarcIlng the Interest t'Onyqed anleu the State fInt lw In hand, a written agreement to be bound u lessee lor all obUgatlona
under the 1_ lor the _Igned portion from the aulpee. ThIa m¡uJrement ahonld not be c:oaaCrued In any way a a release or
redalon of the obUptloaa of any I1I1'CIy bonding parties under the m¡ulmnents 01 the State 011 and gu leau. Board Rulee or this
aulgnment. (Allleueea are ultimately reapoulble lor the perlormance under the leau. and delault subjects the entire 1_ to
£oñeltnre not Just the Interest related to any performance obUgatlon couldered to be In default.)
3) A algued original and one I.'Opy of ed wlgmnent must be ßl!ed with !he Wyoming State landi and Inveslmenta.
I
4) Each ualgmnent, llapproyecf.1s recognized by the Slate a effective a of the date of approval by the DIrector. Adequate bond mlllt
be famished covering any and all produdlve zones prior to approval of any assignment of InteJl!lt In an operating State 011 and gu .
lease, whether wellbores exist on the leased IaDdI or not,. and In no cue can drIIUng operatloaa, including to pl'Olpedlvely
pmdndlve zona under operating leøes, begin without a boua fInt being In place.
S) If there Is more than one party In Interest to this wlgnment, then all .uch pertles In InteJl!lt mUlt lip the dOCllDlent before
aulgnment approval will be given. .
6) The appropriate legIl deacrlpdon of the conveyed IaDdllntereallllUlll be given.
7) Asslgnmenla creating a aepante (reløne) leae IIIIbJed to the mles and regnIatloaa govemlng all State of Wyoming 011 II: Ga Leue
do not c:hmge the terms and condltloaa 01 the origlnalle.ue, the leue annlverauy date, nor the obllgadona and annIvenuy date of
the leue created there from being couldered a If It had been Issued on the effectlye date of the original leue. (See Board Rules,
Chapter 6, Sedlon A.)
8) Corpondona.lImlted liability companies, and Umlled partnenhlpa must be qua11fled with the Wyoming SecretaIy of State'a Office,
and general partnenhlp papen are m¡ulred to be filed with the Stlte Landa and Investment. prior to, and a a condition of Board
approval of any aslgnment.
9) Assignments will not be conaldered for approval where aalgnor or any ...Ignee currently ha. a delinquent (late) royalty or
rental payment obllgatlon(. for any State subsurface resonrce leue.
Notary I"ubllo
KATHLEEN M VAN WAAT
8174 Soulh 26ðO·Eall
G·!ndy, UT 84093
11.1\' ':':ommlls on ExpireD
January 5. 2008
Slate of Utah