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STATE OF\VVOl\ßNG
BOARD OF LAND COM¡\lISSIONERS Retùm To-
On. & GAS LEASE (NTEREST AsSIGNME1'IT Slale Lands &:In_lmenls
..! ...~ .' ,'1 122"West2SthSlreet
. : .. ..; Henchler BuIIdIIIg. 3 West
.:. APPAØ\Lf!DOoz-06OO
Wyomiog OU & Gas Lease Serial Number 05 - 0 0 3 77 AssÍ&t{ment;'PP;I'OVlI DaIe-.-U1ß1 . . 4lin
. Lane Lasrich.· ..: ~.19~
ASSIGNO~ with naïne and address at
2597 East B·~idgèr Blvd-.
Sandy, Utah· 8.4'093
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I!ffectiw 11~
Form ML-2
(RevIsed 4-96)
FWng Fee - $25.00· Non-IWCundable
Being the owner of 100% percent Leasehold
(Type òf Inlens!: LeasehOld/Operating lUghls/Ovenfdlng Royalty)
interest in this lease, described in particular if less than the total leasehold as: .
TOwnship 22 North, Range'116 West, 6th PM, Lincoln County, Wyoming
Tract 59 (formerly All Section 16)
For good and valuable amsideralioI1, hereby assigns to: ...auU"UUU"I.J.U.u.u.~U~~~II~U.u.IUJ.IUUU·~UIIUI.IUU&lU.u.'U.uIUU..&UUJ.UUUA¡L
1) ASSIGNEE,withnan\eandaddressat: Fi tzsimmol}s,· L;LC
2201 Cabin Court
Gillette,-.m. 8'2718·
1 0 0 oercIII\t Interest In the Iotal1eøsehold, or IS described In par~above.
~ interest In the Iotal1eøsehold, or IS described In particular above.
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3) ASSIGNBE,.with name and address at:
percent Interest In the Iotalleasehold, or IS described In particular above.
4) ASSIGNEE, with name ønd address at:
percent interest In the Iotalleasehold. or IS described In particular above.
5) ASSIGNEE, wi!h name ønd address at:
percent Interest In !he Iotalleasehold, or IS described In particular above.
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ønd reserving unto ASSIGNOR:
4.5% of 8/8ths overridinq royalty
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This uslpmeat Is labJed 10 III)' exlsling DftJridIøg myaltlu prnlOlllly ftHI"I'ed. Rl!lenal1oa. of oftllid1øg Interesls mast be IpplVYed by the
Diftdor,.IIId my lach IpJ'IOYalls labJed to the amdItion lhat ovenidIDg myallll!l may be caacelJedby the BOIId of LIDd CoauaIaalcmenlf it
flnda tIIat lath ovaridfD& rvyaltlu aute I bardea on the le_ which prevenls or anreaaoaably latafetes with lis dI!Ye1opIlleDL
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ASSIGNOR certifies by llgøataft OD reven", that ASSIGNOR Is the OWDer of the latetest lbo,"!! here1a lraDsfared" md ASSIGNEE(5
catify(1es) by aJgnias oa the I'ume that thIa asalgmaeDt consllta\es a bInclln¡ acœptiace of all the tmu, coadIIIODI, llIpalallODl, 1I!Ilrkll0Dlmd
llatates govemla ¡ the IeaH desafbed abo"", md of the RaIes of the Board, It OLapter 6, LeuJag of Sabaarfaœ Resoarcu.
This form ""'Y lie dupUalled.
If BpIlœ is needed fór lUlditionø/ RSSignors or l15SÍgnm submit copies of this fórm only.
Page
of _ ofLeøse 1#
assignment dated
//.ló.'1I/{. 'lIJ#
(01)089
By-
11t1e -
. ~.,
My col11DlÌSSÎon cxpires:
)
) ss.
COÜniY'ofSalt Lake )
Bcfoæme, the undersigned, a Notary Public, in and for said County and State, on this 28th day ofMarch 2007 personally appeared Lane Lasrich and Karen
Lasricb, hill wife, 1Otnebown tðbe 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 ficc and voluntary act and deed for the uses and purpOsCs thcteb1 settbrd1.
IN WITNESS WHEREOF' I.bavÞ hcreuntoset me hand and .äf6xed my notarial seal the day and year last abo. ve written. _ "'I
' ---
r - - - - -ÑÕtarY Public I
I REBECCA lEE THOMAS
Ii 8606S:U:-.:e I
" Myc::::ratr"... ,
.~ -"'\te of Utah ..
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N~PubUc ~ ~
State of Utah
AssrGNMI!NTR_nl<UllNn:l
Nolie: AøsI...-- are DOt ",Id IIDtII ~ ~ the Dhmor. ()(fb of8tale Iuds and InveIfmeDIsIS IIeJ' Stale OIl Ie GIÍs Lease
Terms.. and a_lis_I. lor administrative IIaI'DOIIeII and __lei .of be IIIlemreted as WUDII(y that uv Dar(y:= :~
holds leul OJ' eaaftable InIeœIt III this lease. MsII!IUIIeIIIs wIddt do 1ICIt.-l the ~Ifsfed beI";;;;¡
and Kales wID be Rlamed uaDDnJftd.
1) '11ds lorøa.... be CIODIp1eCed and _bmItted lor aøy ~_t of Stale Ollie GIS Lease JeuehoId hdeæst. UJUIiyfAfeel OJ' cQvIded
IS to RpØate ~ fnnnadop, __ or deposits" aadfocOftldcllacnJ1alty fDfaat.
2) AIIIpmeats of_ tIwa a 100% leasehold InIeæsf. do lICIt reIJeft the ISIIpor of the obUplloas IS a IeeIee 1U1der the tams of the
lease ftpI'dIøgthe hderat c:oave,yed 1IIIIeu the Slife ßøt has In haad" I wdIteR agœemeat to be botmd ..1eIsee for all obUpdou
1U1der Ibe lease fat Ibe -'Peel podioø from the -Jsaee. Tb.II rec¡ûemeat ahóald DOt be COIIIIraed·1n Ill)' way .. a reJeue or
œd8lcm·O( the obUptlœa of Ill)' I1II'dy boadJøg pudea IIIIder the ~ of the Slate oB ud pi .-. Board IlaJee or this
aal¡Jo-t (All -- are a1tfmaIeJy ftlpouIble fOJ' the pMwm.~ 1UUIet the Ieue, aad default nbJects the mdre lease to
fod'eItaœ DOt Jut the IDtaat related to uy paformauœ obllpdon tIOII8IcIemf to be In defaaJt.)
8) A lIpeel orf&Inal an4 ODe copy of each -8"-'" ID1IIt be filed willa the WyomIng State Lands ud mveeCments.
4) 1!adI....,,,...'etlt. flaJlllftWed, Is œcopI:œd by the Slate .. e«ectIve II of the date 0( approvl1 by the DIœdor. Adequate boad mast
be famished awerln¡ any aad all pIOdadfve ZODeI prior to Ippnwal of III)' .""IgJo-f oflDleft8t In·u operatIøs Slate oB ud ps .
1ease, whether weIJbor'eI exfsI on the leased Imds or IIDf. aad In IUI case CUI ddUIng operaIiou., lncIadlng to proepedlYeJy
pavdudiye ZODeI anderopeødng IGtet. begin wIthoat a boIIdßøt being In plaœ. .
S) If there Is more tIwa one party In Interest tothla ..1gnmeDt,. then all aach paltiee In IDIeft8t mast lip the docamenl before
....gnment approval wm lie pen. .
6) The appropdate 1epI cIeeafptIon ol the conveyecllmds Intenets mast be sinn.
7) Aulpmenls tteatIng I HpIØIe (œlssae) lease ..bJed to the ra1ee aad æpJatIona governing all State ofW)romlng 011 Ie GIS Leue
do DOt change the terms aad conditions of the odgInallease. the lease annIvenary date. øor the obUptions ud unlvenuy date of
the lease Clateel theft from being considered .. flit Lad been ....eeI on the effective date of theodglnallease. (See Board Rules,
Chaptel' 6, SectIon A.)
8) CorporatIons, IImIteel liability companies. aad IlmIted padn!!llhlpllllllllf be qaal1fied willa the Wyoming Secretuy of State" Office,
and general plllllel8hlp papeø are required to be ffled with the Slife Lands ud mveatmenta prior to, ud .. a condillon of BoanI
approvl1 of Ill)' ..Ignmeøt.
!I) Aulgronents will not be coDlldered for approval wbere asIlpor or uy ..Ignee caøently bas a delinquent (late) royalty or
rentalpaymeat obUgatfon(s¡ for any Slate subsarfaœ resoalCe lease.