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Home My WebLink About873736 r r;"{-('\I'~;\ tr~'~. j t C 1,./ ::.. I 1,/ t. U LI~JCOLN CO:I;\"IY CLEF:;< 0,) ,0' t) 7 '-. '~, q b'- 0", ... J " " '0 ..)". 0'" r I !f\~" --7 '-" n. "f- ,..1 :,", L ;: i 11 ~ ) ~ ...:i".J ~~rL~q~,BTATS~_, . hi" DEPAR IIVI~~,} ,I',,' ElliE INllt..uvR BUREAU 6p; u( MANAGltiMlBNT FORM APPROVED OMB NO, 1004-0034 expires: September 30, 1998 Form 3llllM, (JanullfY 1S96) ASSIGNMENT OF RECORD TITLE INTEREST IN A LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES 46~ ''"\94 !OOK~"':"_:?'_PR PAGE I; ',_ 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-131423 Lease Effective Date (Anniversary Date) February 1, 1994 New Serial No. 1. Assignee. Street City, State, ZIP Code Type or print plainly in ink and sign in ink, PART A: ASSIGNMENT Intrepid Oil & Gas, LLC. 1801 Broadway, Suite 800 Denver, CO 80202 .If more th~n one assignee, check here attached sheet of paper. o and list the name(5) and addr~55(es) of all additional assignees on the reverse of this form or on a separate This record title assignment is for: (Check One) !2J Oil and Gas Lease, or []GQOthQrrnaILeQ$Q Interest conveyed: (Check one or both, as appropriate) [gJ Record Title, o Overriding Royalty, payment out of production or other similar interests or payments 2, This asskmment conveys the followinCl interest: Land Descriotion 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 Township 23 North. Ranoe 114 West. 6th P.M. 100,00% All None * . Of Record Section 26: W1/2 Section 34: All Containing 960_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, LL.C. 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 D Assignment approved for attached land description o Assignment approved for land description indicated on reverse of this form, By (Authorized Officer) (Title) (Date) - - - - - - 08t7~:rr:j6 095 Part A (Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No.1, if needed, or for land Description in Item No.2, If needed. ' STATE OF WYOMING COUNTY OF LARAMIE SS. . . On this 24th day of April, AD_ 2001, before me personally appeared MARC RANDAL STRAHN, President of The Wolf Haven Corporation, to me personally known, who, being by me duly sworn, did say that he is the President of The Wolf Haven Corporation and that the seal affixed to said instrument is the corporate seal of said corporation and that said instrument was signed and sealed on behalf of said corporation by authority of its Board of Directors, and said President acknowledged said instrument to be the free act and deed of said corporation, Witness my hand and seal this 24th day of April, A,D. 2001. \J) (JIl.--~ -f}.).O 'f~o--n"-rJ'-.P.;J Notary Public " I My Commission Expires: Address: Cheyenne, Wyoming ":'v~,A,~v~;..'...$~~V :-v.':... ~ o;SriI~ONNS.~~ ' NOTARY PUEll-IC COUNTY Of STATE Of LAR....IlllIt: WYOMING MY COMMISSION EX'~IflES JUl. 16, 2003 .1~1.;:.~~~~.; "'~~~ 1. The Assignor certifies 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 certlfills as follows:(a) Assignee is a citb:en of the United states; an association of such citb:ens; a municipality; or a corporation organized under the laws of the United States or of any State or territory thereof, For the assignment of NPR-A leases, assignee is a citizen, national, or resident alien of the United States or association of such citizens, nationals, resident aliens or private, public or municipal corporations, (b) Assignee is not considered a minor under the laws of the Stale in which the lands covered by this assignment are located; (c) Assignee's chargeable interest. direct or indirect, in each public domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases ( of which up to 200,000 acres may be in oil and gas options), or 300,000 acres in leases in each leasing District In Alaska of which up to 200,000 acres may be in options, 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 geothennallease; (d) All parties holding an interest in the assignment are othelWise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizin9 Acts; (e) Assignee is in compliance with reclamation requirements for all Federal oil and gas lease holdings as required by sec. 17 (g) of the Mineral Leasing Act; and (f) Assignee is not in violation of sec. 41 of the Mineral leasing Act, 3. AssIgnee's signature to this assignment constitutes acceptance of all applicable tenns, conditions, stipulations and restrictions pertaining to the lease described herein. For geothermal assignments, an overriding royalty may not be less than one-fourth (1/4) of one percent of the value of output, nor greater than 50 percent of the rate of royalty due to the United States when this assignment is added to all previously created overriding royalties (43 CFR 3241). I certify that the statements made herein by me are true, complete, and correct to the best of my knowledge and belief and are made in good faith. Exe~ this 24th day of April ,20 01 Executed this day of ,20 01 Assignor or Attorney-in-fact Intrepid Oil & Gas, L.L.C. Assignee ~ or Attorney-In-Fact P,O. Box 2480 , ' \' ,-, , , , : ' ,', (Assignor's Address) CheYe')~J6r2.W~! IJ .. ," 1 )..',.. >" (State) "'I.... (.J'.. . <....... (Zip Code) Pu~ic portil'lf ug::tell..fg)tI1is~rW is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and coll'l~tJng ~ re~w~e fol:i'n~ Direct comments regarding the burden estimate or any other aspect of this fonn to U_S. Department of the Interior. Bureau of land MlihagemeCBu"'au C!earam::e:C8!icer, (DW-11 0), Denver Federal Center, Building 40, P. O. Box 25047, Denver, CO 80225-Q047, and the Office of Management and BUd" ,:Pa 0 . ion:e"lct 1004-0034. Washin on, D.C. 20503 TitlEJJ,!tUS. ee. .a a crime for any person knowingly and willfully to make to any Department or agency of the United States any false, fictitious, or fr8'ogi:l1,ht s~atement~.ar' rtlP(eSentations as to any matter within ~s jurisdiction. , 1,/: ~ ::i:.I \, \,. *U,S. GPO: 1992-n4-o17/67022 f ! -: ( ~ 1 ' ; \ '. \ ~ ~ ~ 0873r'l:lG ACKNOWLEDGEMENT 096 STATE OF COLORADO ) CITY AND COUNTY OF DENVER) On the 30th day of April, 2001, personally appeared before me Robert p, Jomayvaz III who being by me duly sworn did 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 Conunission Expires: 9/28/01 \\\\\\\\\1\111111111//111 ,,~\ J P '0.'" ~ c'C ..'... Ob'~ ~~"-~,.,,. ..',.0 ~ ~~.' ',? ~ ~':J"" ~OTAh}. ,( ~ =:'_101': --... 0 GIl- ~*~ ;:0'1'.: - : == ~ ,,,~ :0$ ~.\,I'-,,', PI"BII,Co :", ~ ~ ,.. . .I..... . ~~ ~"? "'. ..' ~~ 'h /'b.'" ..' ~ ~ ~ C'. '...... 0 ~ ~; 0;: CO\": #- ~lllillJlI/llI\\\\\\\\\~ - - ~f~~ N ary Public Address: 1801 Broadway, Suite 800 Denver, CO 80202 -