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(Date)
(Title)
(Authorized Officer)
By
o Assignment approved for attached land description
o Assignment approved for land description indicated on
reverse of this form.
o Assignment approved for above described lands;
Assignment approved effective
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.
Subject to the terms and conditions of that certain Letter Agreement dated April 20,
2001, by and between The Wolf Haven Corporation and Tom Brown, Ine.
I:P~nshiD 23 North. Ranoe 114 West. 6th P.M.
S~ion 04: Lots 1 (42.54), 2(42.42), 3(42.30), 4(42.18), 81/2N1/2, 81/2
S~ion 05: Lots 1 (42.07), 2(41.95), 3(41.85), 4(41.73), 8112NE1/4, SW1/4NW1/4,
~ W112SW1/4, SE1/4SW1/4, SE1/4
Section 06: Lots 1(41.71), 2(41.77), 3(41.83), 4(49.35), 5(47.12), 6(47.13), 7(47.13),
S112NE1/4, SE1/4NW1/4, E1I2SW1/4, SE1/4
Containing 1,893.08 acres, more or less
Lincoln County, Wyoming
* * It is the intent of this assignment that The Wolf Haven Corporation will deliver
unto Tom Brown, Inc. an 82.50% net revenue interest in this lease, retaining S1
overriding royalty interest equal to the diffetänéé between 17.50% and all presently
existing and outstanding lease burdens which shall ¡ndude lessor's royalty and all
overriding royalties or similar interests burdening the leasehold.
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OOK"~ ._PR P AGE_ J t ____
None I, i ¡:- ,:, \~,;7!· ,/ Qf.l1,fiGd,rd
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1:do.bò~ ti u tAli
Percent of
Retained I JOY~r~i~.¡k:~yalty
¡ ol::.Siri'iifar rntere~
L! Iii C: C Rè$et.)(éèl:,), IflPteiAótl!;I}f\
reserved
'. qr,C;OF!yeyed
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d
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Percent of Interest
Owned I Conveyed I
o Overriding Royalty, payment out of production or other similar interests
or payments
o Geothermal Lease
a
n~
Li·
This record title assignment is for: (Check One) 181 Oil and Gas Lease, or
~nterest conveyed: (Check one or both, as appropriate) 181 Rt¡!cord Title,
o and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate
*If more than one assignee, check here
attached sheet of paper.
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
Tom Brown, Inc.
555-17th'Street, Suite 1850'
Denver, CO 80202-3918
1. Assignee·
Street
City, State, ZIP Code
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-143676
Lease Effectiv~ Date
(Anniversary Date)
Decemb~r 1, 199'1
New Serial No.
ASSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
FORM APPROVED
OMB NO. 1004-0034
Expires: 8eptember30, 1998
UNITED STATES
DEPARTMENT OF THE IN1ERIOR
BUREAU OF LAND MANAGEMENT
Form 3000-3
(January 1996)
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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 23rd day of April, A.D. 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 ~y h~nd end seel this 23rd day of April, A.D. 200b, ^ ~ .
PEGGY.f LUPlo¿ - ,.OlARY PUBLIC ~ (.
COUNTY OF STATE OF
My Commissi E~~j}~~: WYOMING
MY COMMISSION EXPIRES MAR, 19,2003
'~~;~;~:';'<"<"""/"~
'rforßõ
Address: Cheyenne, Wyoming
I'
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ACKNOWLEDGMENT
STATE OF COLORADO)
)ss.
COUNTY OF DENVER )
On this ~ day of May 2001, before me, Gail A. Bates, a notary public for the State of Colorado
I ~~:o~~~~Pieared ~~dne~ G, ~~",Jott 'IW~r ac~owledged himself to be the Vice President - Land of
instrument f~r :~'paurpn oseat ;''I\&~M~~4~!ldent, being authorized so to do, executed the foregoing
s ~efðYiì.çontalu~~ ('n~
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i ! ~OTARy\ ~ .
:. ':~ IJ "A -.=í\
My Cornnússion Expires ª : ~ : jota}p~.-.aG <,;) '1 ~ "'B ""-"- '~
May 14 2001 ~" Pu (': . . c. al e ates
. - ~ <.1).... B L \ \)/ esldmg at 8335 Fairmount Dr.,
'\ '1'».... ...~~ ~Denver, Colorado
- ~..;~'a;·;~t~?-W,#
rate of royalty due to the United ~tates wnen 1m:; é:I:;::'I!, 11I (~t".",~....a.~~ ...._.._ __., _ ,
,20 01
Tom Brown, Inc.
<:--
A. .../ President
o· Atte~t 'Req'ùired
. .
P.O. BOX2~80: ::. ~,".':\:':~:;', ,.'.
. (Assignor's Address)
Assignee
x9l
~
ATTEST:
Cheyenne, WY 82003
(City)
(State)
(Zip Code)
Public reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land
Management, Bureau Clearance Officer, (DW-110), Denver Federal Center, Building 40, P. O. Box 25047, Denver, CO 80225-0047, and the Office of Management and
Budget, Paperwork Reduction Project (1004-0034). Washington, D.C. 20503
Title 18 U.S.C. Sec. 1001 makes it a crime for any person knowingly and willfully to make to any Department or agency of the United States any false, fictitious,
or fraudulent statements or representations as to any matter within its jurisdiction.
*U,S, GPO: 1992-774-017/67022.
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