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SIBle Lands 6: Jnwslmenll
121 West 25th Street
HencbIer BulldJng.3 Weat
~ Wr B2OO2-416OO
APPROV~
(JUN 1 9 7001
I!ffecUve 11-16
Form ML-2
(RevIsed 4-96)
FIIiIIg Fee - $25.00 - Non-Refundable
STATE 0.'" WYO~ING
BOARD OF LAN» COM\WSSIONERS
OIL & GAS LEASE(NTEREST AsSIGNMENT
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Wyoming on & Gas Lease Serial Number 05 - 0 0 378 &sígJ...eittÀp.j..oval DaÌe-
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ASSIGNO~withnaïneandaddressat:· LaIle Lasric4· .. '.
2597 East B·~idgèr Blvd".
Sandy I Utah·' 84'093
Beingtheownerof 100% pm:ent Leasehold
(Type Of Jnleælt Leuehci1d/Operatlng R/¡h1l/OverrIdIiIg Royalty)
interest in this lease, described in particular jf less than the total leasehold as:
Township·· 22 ·Nor·th, Ra.nge· 116 West,·· 6th PM, Lincoln County, Wyoming
Lot 8 (fotmerly Pt. S~SW Se~tio~_35)
For good and valuable consideration, hereby assigns to: u.......u..Uu.u.&u...u~_~u~~~.."~U~..&IAUUUU~...UUII.UUUi.tUUUU.,UUIUUUU,UIU
1) ASSIGNEE, with name and address at:
Fi tzsinuno~s,: L;LC
2201 Cabin Court
Gillette.,. . wy 82718
pen:ent interest in tþe total leasehold, or as described iI'i ~Above.
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2) ASSIGNEE, with name and address at
pen:ent inlerest in tþe total leasehold. or as "described in particular above.
3) ASSIGNEE, .with name and address at:
percent inlerest in the totalleaseho1d, or as described in partkuIør above.
4) ASSIGNEE, with name and address at
pen:ent inlerest in tþe Iotalleaseho1d, or as described in particular above.
5) ASSIGNEE, with name and address at:
pen:ent interest in the total leasehold, or as descn"bed in particular above.
and reserving unto ASSIGNOR:
4.5% of 8/Sths overriding .royalty
Tbfa "slgament Is labJect 10 any existing oRIridfDg lII)'Illiel pmloasly _cd. ReaervalimU of ovaridfDg mlerala mast be approyed by !he
Dlm:tor, and any llIda approval Is labJect 10 the cODdfliou that oYCrdclføS lII)'Illiea my be waceUed by !he Boant of lind CøauølsåODell if It
fInda that llIda overddføg royaldea cnaIe a banIe.a on the leae which JlftYull or ure_bly fnterferea with III cJeye1opment.
ASSIGNOR cerliflea by Ilguatare on revene, that ASSIGNOR Is the owner of the lId_t abov~ herein transfmed" and ASSIGNEE(S)
certIly(lea) by llgaføg on the l'evene that this aaalgnment CODSlitatea a blDcUng acceptåDce of all !he terms, coadflious, ItlpaJalious, reabictlona and
l!atatea &ovemlDg the leue deacrlbed above, and of the Ralea of the Boud, at Chapter 6, Leuiag of Sabaarface Reaoan:a.
This form ""'Y lie dupliIJ/led.
If 6plIΠis needed for Ildditiotud lISSignors or IlssigtreeS submit copies 01 this form only.
Page
of _of Lease 1#
IISsignment dated
tl¡;'4."
OûÐ085
.')fJ.2.,L.
Title-
Lasrich
ouse
mDDnDUALACKNOWLEDGMENT
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 Lane Lasrich 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 REoUDI.EMENTS
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Notary Public
KATHLEEN M VAN WART
8174 South 2660 East
S,1I1dy, UT 84093
My Commission Expires
January 5, 2008
State of Utah
My commission expires:
OJ_ðS'- 011
Notary Public ~ ~ /ì1. (;2, ¡j ~
Note: Asslpments ue not valid until apÐI'OVed bv the DIredor. OEfIce or State Lands and Investments as øer State Oil&: GM Lease
Terms. and apDIOval Is IOlelv for admlulstratlve DIU'pOSes and should not be InterPreted as warrantY that anv DaJtv to this uelmment
holds leal or Multable Interest In this lease. Aeslmments which do not meet the reaulrements 1Ieted below and those In the Lease
and Rules will be retumed unapproVed.
1) ThIs form IIUIIt be completed and aubmltted for any assignment of Slate on &: Gas Lease leasehold Interest,. undivided or ~vlded
as to separate tracts, formations. zones or deposits, and for overriding royalty Interest.
2) AssIgnments of lees than a 100"10 leasehold Interest, do not relieve the uelgnor of the obligations as a lessee under the terms of the
lease regarding the Interest conveyed unleee the State fint has In hand, a written agreement to be bound as lessee for all obligations
under the lease for the assIgned portion from the assIgnee. ThIs requirement should not be construed In any way as a release or
recisIon of the obligations of any surety bonding parties under the requirements of the State 011 and gas lease, Board Rules or this
assignment. (Allleseees ue ultimately responsIble for the performance under the lease, and default subjects the entire lease to
fmfelture not just the Interest related to any performance obligation considered to be In default.)
3) A signed original and one copy of each assignment must be ffied with the Wyoming State Lands and Investments.
4) I!uh assIgnment, 1£ approved, Is recognized by the State as e£lectlve as of the date of approvsl by the DIrector. Adequate bond must
be furnished covering any and all productive zones prior to approval or any assignment or Interest In an operating State 011 and gas .
lease, whether wellbores exist on the leased lands or not, and In no case can drIIUng operations, including to proepedlvely
productive zones under operating leases, begin without a bond fint being In place.
5) If there Is more than one party In Interest to this assl$ßIDent, then all aum parties In Interest must sign the dOCUlllent before
uelgnment approval will be given.
6) The appropriate legal desaiption of the conveyed lands Interesta must be given.
7) AssIgnments creating a separate (reissue) lease subject to the rules and regulatIons governing all State of Wyoming Oil&: Gas Lease
do not change the terms and conditions of the original lease, the lease annIveraaJy date, nor the obligations and annlvel'Sal)' date of
the lease created there from being consIdered as 1£ It had been Issued on the effective date of theorlglnslleaee. (See Board Rules,
Chapter 6, Section A.)
8) Corporations. limited liability companies, and limited partnenhlpe muat be qualified with the Wyoming Secretuy of State's Office,
and general partnel'lhip papel'l are required to be filed with the State Lands and Investments prior to, and as a condition of Board
approval of any assignment.
9) Assignments will not be considered for approval where assignor or any assignee currently has a delinquent (late) royalty or
rental payment obllgatlon(s) for any State subsurface resource lease.