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FOlm 3(XXl-3
(June 1988)
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UNITED ST A'I:..ES
DEPARTMENT OF THE"INTERlOR
BUREAU OF LAND MANAGEMENT
FORM APPROVED
OMB NO. l004...{)Q34
Expires: August 31, 1989
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93 C\J I .:. J
r',! 0.: 00 ASSIGNMENT OF RECORD TITLE INTEREST IN A
h.' .. LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
Lease Serial No,
1;<1-113647
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Mineral Leasing Act of 1920 (30 U,S_C. 181 et seq.)
Aq for Acquired Lands of 1947 (30 U_S_CO 351-359)
Geothermal Steam. Act of 1970 (30 U,S.C. 1001-1025)
Department of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.Co 6508)
Lease Effective Date
(Anniversary Date)
December 1, 1988
New Serial No.
1_ Assignee*
Street
City, State, ZIP Code
,{(Ct/UC...7 _ he.i
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*If more than one assignee. check here 0 and list the name(s) and addressees) of all additional assignees on the reverse of this form or on a ~
separate attached sheet of paper.
T
n in ink.
PART A: ASSIGNMENT
Energy Partners Nonunee Company
c/o Duncan Energy Company
1777 So. Harrison Street, Penthouse One
Denver, Colorado 80210-3925
This record title assigrunent is for: (Check one) ~ Oil and Gas Lease, or 0 Geothermal Lease
Interest conveyed: (Check one or both, as appropriate) H Record Title, 0 Overriding Royalty, payment out of production or other similar
interests or payments
2, This assigrunent conveys the followin interest:
Land Description
Additional space on reverse. if needed. Do not submit documents or agreements other than
this fonn; such documents or agreements shall only be referenced herein.
Percent of Interest
Owned
Conveyed
RClllined
Percent of
Overriding Royalty
or Similar Interests
, Reserved
This Assignrrent is made pursuant to and subject
to the Participation Agreement dated December
15, 1992, betw'een Celsius Energy company and
Energy Partners Nominee Company, as amended.
46t-! 0 4
nooK.",_.. _ f~,..PR PAGE_~.__,.~_
HE CE \\1 E '~{
JNCOLN COG\'!
6.5% of
8/8ths
prop:::>r-
tionate y
reduce
by the
intere
assign
Previously
reserved
or conveyed
f
none
a
b
100%
c
d
75%
e
Township 18 North, Range 113 Hest, 6th P.~1.
25%
Section 2: lDts 1-4. S/2N/2, 5/25/2,
(Less 25.Z5acres, mil in the
UPRR RA~ 10-21-1868)
Containing 453.95 acres, rrore or less
Uinta County, Wyaning
ClER\
19d
, ,J" .3 FOR BlM USE ONlYri1D9\t!Plr,wR,' B:t:t . THIS LINE
.. . f/?""/O .. . UNIT'eb\S'l'ATES?~ A~,E~~ji'lER. ..
This assignment IS appr~edI ~e~ €\r 'Jdrmrustrative purposes. St~~\tl dad .o?\' ~Wft~iit that either party to thiS asSIgnment holds legal or
eq\lita~le title to this lese I. \\E.M M E g Eft, \~ '
,'lJ ASSIgnment approved for above descnbed lands; 0 ASSignment approved for attached land description
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, . , NOV 01 1993 , ' n~ ~ ::..,:v! ~ '_ ,,' '\__
-\sslgnment approved effectIve 0 ASSignment approved for land description indicated on reverse
, of this form,
d4i(~(_ ~e k~-'
f::PERVlSORY L~\9LAW EXAM!;~2;l
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Part A (Continued):
ADDITIONAL SPACE for Names and addresses of additional nssignees in hem No, I, if needed, Or for Land Description in hem No.2. if
needed,
08t7410J
205
\
, CERTiFIEQ
10 be n true and comrmratlve copy
of ths official records on fila
STATE OF UTAH )
COUNTY OF SALT LAKE ;ss-
On the 22nd day of September 1993 person all a ed b n
~;n~lrn s;e~~f ~~d ~a ~at he i~ the )Preside~t If t'=s E~~r~;e ~~~p~y) ~d ~:td~d ::~~~~~g w~;
Nordloh acknowledged to :Oe thratiton .bdY authonry of a resolution of Its Board of Directors and said G L
a S<U COrporatIon executed the same. . .
JUN 1 9 20pf' .., "
jt/4r& ~/~V
BUREAU'5FUW MAr~AGEMENT
__My commiss!o~ 'expires:
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tiJ.~~/ 7f? dc?~7~o___
Notary PublIc
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PART B: CERTIFICATION AND REQUEST FOR APPROVAL
1, The assignor cenifies as owner of an interest in the above designated lease that he/she hereby assigns to the above assignee(s) the rights specified above.
2. Assignee cenifies as follows: (a) Assignec is a citizen of the Uniled States; an association of such citizens; a municipalily; or a corporation organized under the law;
of the United Stales Or of any Slate or territory thereof. For the assignment of NPR-A leases, assignee is a citizen, national. or resident alien of the United States 0
association of such citizens, natiOnals, resident aliens or private, public or municipal corporations, (b) Assignee is nOI considered a minor under the laws of lhe Stat<
in which the lands covered by this assignment are located; (c) Assignee's chargeable inlerests, direct and indirect, in eilher public domain or acquired lands, do nOI excee(
200,000 acres in oil and gas options or 246,080 in oil and gas leases in the same State, or 300,000 acres in leases and 200,000 acres in oplions in each leasing Distric
in Alaska, if this is an oil and gas lease issued in accordance with the Mineral Leasing Act of 1920 or 51,200 acres in anyone :State if this is a geOlhennallease; (d) AI
panies holding an imerest in the assignment are otherwise in eompliance with the regulations (43 CFR Group 3100 Or 3200) and the aUlhorizing Acts; (e) Assignee i
in compliance with reclamation requiremenls for all Federal oil and gas lease holdings as required by sec. 17(g) of lhe Mineral Leasing ACI; and (f) Assignce is not i,
violalion of sec. 41 of the Mineral Leasing Act.
3, Assignee's signature to lhis assignment conSlitules acceptance of all applicable terms, conditions, stipulations and restrictions pertaining 10 Ihc leasc described herein,
For geOlhermal assignmenlS, an overriding royalty may nOI be less lhan one-fourth ('A) of one percent of lhe value of OUtpUl, nor greater Ihan 50 perccnt of lhe rale of royalty
due to lhe United StaleS when this assignment is added to all previously created overriding royalties (43 CFR 324]).
I cenify thaI lhe stale men IS made herein by me are true. eomplete, and correct l(l the beSt of my knowledge and belief and are made in good failh.
, Executed this
21st
Executed this day of
ENERGY PARTNERS NOMINEE COMPANY
Name of Assigno~ as shofn on,~current lease I Celsius Energy Conpany ~' ",
PI I c/ /~'
". jf " '! " ease Iype or print ~
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Assignor "-~' '.J-x: / l\ttest: ! / Assignee' t ~C ' .
.& ;Y '(S;gnaIU're,f'\'" I ' P B E J h < Il?'gnalure) V - P . d
Or 1- or uce . 0 nst;.fl;"'- lce reSl ent
Allorney-in-faCI President f ~ A---J c, j (c" ,-, Attorney-in-faCl /
- (Signaiure\Asst. Secretary ATTEST: ~ (Signature)
P.O. Bo4_ 11070\ -E _ //
(Assignor's Address) '''-l By: (oR -:: L r<::L /_
Salt Lake City, Utah 84147 Leon R. Bailey. Assistant Secretary
(Slate) (Zip Code)
22nd
day of
September , J 9
93
October
,19 93
(City)
Tille 18 U,S,C, Sec. ICXl! m.lkes it a crime for any person knowingly and willl'ully to make to any Department or agency of the United $l:lIe,< any falsc. fiC:lil;(luS or fr;luJuknt
Sl~lIr"llClllS Or reprcscntulion.s as 10 ;Iny Jl\atlcr within ils. jurIsdiction,
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