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Form 3000-3
(Janulli)'1996)
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DEPARMN1 QF.Fl}E'~r.rm~lbR
BUREAU OF LAND MANAGEMENT
FORM APPROVED
OMB NO, 1004~0034
Expires: September 30, 1998
ASSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
BOOK_~6f.ipR PAGE fl ~ '], Mineral leasing Act of 1920 (30 U,S:C, 181 et seq,)
Act for Acquired lands of 1947 (30 U.S.C. 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'-C. 6508)
lease Serial No.
WYW-136361
lease Effective Date
(Anniversary Date)
May 1, 1995
New Serial No.
1.
Assignee*
Street
City, State, ZIP Gode
Type or print plainly in ink and sign in ink,
PART A: ASSIGNMENT
Intrepid Oil & Gas, L.L.C.
1801 Broadway, Suite 800
Denver, CO 80202
*If more than one assignee, check here
attached sheet of paper,
o and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate
This record title assignment is for: (Check One)
I2l Oil and Gas Lease, or
o Geothermal Lease
Interest conveyed: (Cfieckone or-both, as approptfate)
i:8J Record Title,
o Overriding Royally, payment out of production or other similar interests
or payments
his assIgnment conveys e ollowing interest:
Land Description Percent of Interest Percent of
Additional space on reverse, if needed. Do not submit documents or agreements ONned Conveyed Retained Overriding Royalty
other than this form; such documents or agreements shall only be referenced or Similar Interests
herein. Reserved Previously
reserved
or conveyed
a b c d e f
Townshio 23 North. Ranoe 114 West. 6th P,M. 100.00% 100,00% None .. .. Of Record
Section 14: All
Section 22: E1/2E1I2
Section 23: N1/2, SW1/4, N1/2SE1/4
Containing 1,360,00 acres, more or less
Lincoln County, Wyoming
.. .. It is the intent of this assignment that The Wolf Haven Corporation
will deliver unto Intrepid Oil & Gas, L.L.C. an 84.00% net revenue
interest in this lease, retaining an overriding royalty interest equal to
the difference between 16.00% and all presently existing and
outstanding lease burdens which shall include lessor's royalty and all
'overriding royalties or similar interests burdening the leasehold,
Subject to the terms and conditions of that certain Letter Agreement
dated April 20, 2001, by and between The Wolf Haven Corporation and
Intrepid Oil & Gas, L.L.C,
2
T
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FOR BlM USE ONLY - DO NOT WRITE BELOW THIS LINE
UNITED STATES OF AMERICA
This assignment is approved solely for administrative purposes. Approval does not warrant that either party to this assignment holds legal
or equitable title to this lease.
o Assignment approved for above described lands;
Assignment approved effective
o Assignment approved fur attached land description
o Assignment approved for land description indicated on
reverse of this form.
By
(Authorized Officer)
(Title)
(Date)
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ACKNOWLEDGEMENT
STATE OF COLORADO
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CITY AND COUNTY OF DENVER)
On the 30th day of April. 2001, personally appeared before me Robert P. Jornayvaz III
who being by me duly swomdid say that he is the Attorney-in-Fact for Intrepid Oil & Gas, LLC,
and is authorized to execute this assignment.
Witness my hand and official seal.
My Commission Expires: 9/28101
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Address: 1801 Broadway. Suite 800
Denver, CO 80202
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