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Home My WebLink About939740 Form 3000-3 (January 1999) ..,;uNlTED' STATES, DEPARTMENT OF TIfEINTERlOR BUREAU,OF 'LAND,MANAG;EMENT FORM APPROVED OMB NO. 1004-0034 Expires:, December31,2001 ASSIG,N,MENJ,OFRECORD TITLE INTEREST IN,A lEAS'E FOR: Oil AND; GAS OR GEOtHERMAL RESOURCES Lease Serial No. W 71773 Lease Effective Date (Anniversary Date) 06/01151 COC023 Mineral Leasing Act of 1920 (30 D.S.C. 181etseq.) AcHor AéquiredLandS of 1947 (30 U.S.C. 351-359) GeotheI1I13lSteamAct of1970 (30U.S~C. 1001-1025) Departmentor:::the~IiiteI'¡:dr'App:ropriatioDS Act,:'FiscalYear 1981(42' U.S.C. 6508) , New SeriaINo. Type orprlnt:p1:alhly'ln Ink¡'andslgn In Ink. " '..>:/ 1. Assignee* Bryan A. Mau SWæt 7437 Dallas Drive City, State, ZIP Code , Au st in, TX 7872 9 P~RT A: ASSIGNMENT *If more thanoneassignee,checkhereÜ and list the näme(S)andaddiess(es~:Ôrål1additioIJ.a!.asSi~eeson thereverse~öfthis form or on a separate attached sheèt of paper; " ' , This record title aSsignment is for: (Check one) 0 OilancÍ.,Gas Lease, or 0 Geother:malLease , Interest conveyed: (Check one or both, a.rappr;priâte)i~ Recora'Tití~, G:3'o;~rriding R~yalty, paYment out of-production or other similar , .,', ,;~:g;~~~~;,9:&~~~~~. " 2. ThiS assignment, conveys itlïei;f6l1o\Vji¡'#Îí~i~'f;:";"::~ ···.:I:;X;·.:¿':'¿,~.'·~¡;:~t;..S;;::;,1:;;.;jj0j¡~':~;::;:;;1ir9~ip·;,:,;.¡::;;¿~.;,::: ;....;/',::.."'''"\;¿,,i;%,',,;;.;',ii;t',i:~'''¡;,:,.. "' Larid,.])escn, tiOD': ,', /Rercentii:of.:'Ihterest¡).I>!.(j, " ":";¡;;'''!!.E!Brti8'lÌt\fôf:~\ i.', '. ,,' . A~tional space ~n reverse, if needed. Do' not sub~t dtJCriÌne?~ 'or"~greè~énts. other than :, :'..: :0Wn~':. ~"~on:v~y~': ,~~~~ëd,..:: ,~;.;';;;:S~~~::~:' " this form; such documents or a~ment.'l shall omy' be rerere~Qèâ:'lîerein. " .,', ,'" ' '"., , , .: ,Reserved. ' ". ",Ìbviously, ,reserved or; conveyed f ^' "... a ,b c d e , '. Township 22 North, Range 112 West, 6th P.M. Section 29: NW 1/4 NW 1/4 Lincoln County, Wyoming Containing 40 acres, more or less .3125 .3125 None .. RECEIVED 6/13/2008 at 10:13 AM RECEIVING # 939740 BOOK: 697 PAGE: 23 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY FORaL'M\US'EO.NlY-;C8:N:ç>T,,wRI'FE.'BELOW THIS LINE ''UNrrED;'S:tA"T-ESI,op::AMER1CA, This assignment is Approved solely. for administrative purpoSes. Approvaldoes not warrant that either party to this assignment holds legal or equitable title to this lease. o Assignrnentapproved for above described 'lands; OAssignmeritapproved for attached land description Assignment approved c::ffective o Assignment apP"Öved'for land description indicated on reverse of tJûs form. By (Authorized Officer) (TitIe) ".' _. - ~ ¥. - "". _. ~ ._~ _0. _~ __ _ __. _.... _. .. _, __, __. _ _ _ ~ , (Date) Tear PART C: GENERAL INSTRUCTIONS Tear 1. A.5signorl A.5sign~(s), must completc,Parts,Al.and ;\2, and Part B., A1l.opartiesto 5.!! any;payment'out.ofproduction'or sími1ar interests, arrangements or payments assignment must sign. as, follows~ Thc,assignor(s)' mustIDaIlll!!!ly,;sig!l:}.orjginal ',have,previooslydx:enrcreated'1outo:ofithednterest,being'assigned,or,ifany, '.such copies and the assignee(~) mustmanually.sign 'at least: :l,oftJie'30rig1naIcopies.payments'OI'intercsts,are~EY~:I;uncJe;¡,thùFassi~"include.a¡sm~IDI!,ut:giving File three (3)completcdcopies ,of this,form.in. theproper::BU;{"officeÆor;c:ach full detàilsas üHlmouIlt"niCthodOfpayment, and other pertinent tennsas provided assignment of tecordtitIe. For a transfèr of:overridiJipoywty iliterest; .payn1ent under 43,CFRJI06,.,3135¡:or¡3241. out of production or othei- similar,interest orpaymetlt,file~one(l}riiarnuilly signed 6. Thedeascaccount'most:,be'ii:¡)good'SfJlnilingibefore.this<'aSsignmei1t">1~an'be ap- copy of this form. The required' filing:.fee (nonrefundable),must'w;cpmpany'the, 'proved,'as.:.provided>under 43"CFR:3106_and:324L assignment. File, assignment within ninety,,(90) clays after, date: of ,execution; of.. , 7. Assig¡¡mcnt. if approved, ,tak:es'cffectonthe firstday;of the month following the assignor. , ,date'of'fiÎíngiri.tliC'.pró#''Bar:offii:c'.lfa~bond is neces~r itDI11l!t,be fur- 2. Sepan¡u: form must be used for each lease being affected by this-assignmeut and :liished'þnor"tò'approtåfof'thê,'issigmnént.', ' ,...,. '" for each; type of intçrestconveyed. , , " 8. Appro,val of assigmnent,.pf.record;µt1ctQ lpo% o(Ii'porD0n of.tIJe'},~Jands 3. In,ItcInNo.2 of'Pan A" de3Cribelands'affected,(Sec43 CFR,'3'106/3135¡or .creatëSSèpanúc1êases0fllìërdJiillfxtandthca,sšt~,~,;bùt(l()es~~e 3241). For columns ,b. cj·d" ,and ..c, enter'theinteresf'expressedlàS>a''pcrcentagethiftêItri$:andcånditiòns 'of thelCaiðanùivèrsárydâtê\fotpurposes of þayment of,totalinterestin the·lease;,,·e; g.,.if,·assignor;assignsone, q1l3IWr 'of a 20%'in- ofannual"rental. ' terest, enter 20% in column"b, 5 % in column c, and 15 % incolumnd. 9~Ov~rri~;'~Ya1tY, payÎDent out'ofpt'oductionor other sÍl'lìillirtypeso{ transfers 4. If assignment:is,to:morethan 'one,assignee,cnter,eath.assignec's:nameacrossmost be',filocLwith BLM, but will be accepted for record purposesotily: No oID- ' columns, d, ,e, and! next to the respectivc'interest being,conveyed.Also list names cw approval' will be given. ' and address.esof any. additional assignee(s) on reverse of this fann or on.a separaU¡ ãtt;;ChM ..heet of niI""r, ~.. --.- -.- PAPER'WORKlŒD A..C:r.sTATEl\1;ENT 1. Thisjnfonn~iion isbemg,eol1ectedpursuant-tmthe law. . 2. This'1information'wilf be·'used.to create and, maintain a record of"oiLan& g~/g~Qtþ.ex:rnaUeaseactivity. . 3. ..~P;þMMQ_¡þis-re.qµest'lis: required to,:obtain :benefit. ',," "-:11'(':; '::" BLMi.Wo:w.d:like'you~tO!<know that you do not 'have· to respond to:tIiiš,i'oriariytöftíe? Federa:bg~cŸ spQ.nsored~information coI1ection, unless' kdispla,ys:a:currentlÿ' vali~Q~B,:co,nt,l:~I':num1?er: . N'OTIct- TheáW"v.acy. .AC~iºf:.lQ74,~,w.e.,regulatipn, in.4~,C;~;2.48@,¡prpxi4¡:¡¡$.!!.W9Q';¡~' fur:ij,iSIie¥~~;t:¿¡~9w·ïn,&"inW~on.in.co.nn~ç);¡wirh~info.~tion'~qr-~!~~this oil...and:;W1~¡;~~~,~I~eWl:(;ord"t1tle ,asslgnment..appli,QúlQn.., .,,,..," ..",.",.,~ A~Q~;.:3~~~;~¡:.~_'1~~::e;eC!;, 30 'u~s.c-,:,~OO'k~1~;.4~"lÙ,;8~::~~: PRINÇU'AL.P~':;¡E-'i.:p¡.~jnfor¡J,J,Rtii:!n:js, to,be,.us~c:tt,qf,pro:c:~~s,r.ecord:titl.t;,as- signmen,ts;for~Qil~d¡:g1\S~geQt1J,c~~ources ,Ieas¡:s. ' 'ROUT. .,~-USES:. O· '024 " ," ~. ~' (l):1;J)c..,aijjul:!iç,a..tion of the assignco'srights to the land or resources. . ~il; ":"':':..~:':',.~.~.~~..!..~.' . ·.-i-:'~;\~~ .-. ,,' .,,:. , ", orpublicinformiuion in support of nQtations.(I13£1& on)anci.:status gement, dispoSal. and use of public lands and resources, :¡?'I#,te'FMeral agencies when concurrence is requ~ prior to ,,\,y,...."f"" E¡'~l ,,_ ,,'~~ll;bli~:: anW."or resources. .. ;(~(S)¡'In,førmatio~~,fuomïthe=rdandlor,'the'rccord will be trïmsferred to appropri- :,a¢ie.~~'SbIte~IQciilior:forcign'agencies,when'relevant to'civil, ,criminal' or regula- to.w..~'{ . ..··prosecutions. " ",Øy.mINGJll,:lFORMATI0N-.,If:øJl;'requested'infOt1Wl- ,:tio ' 1IISSÌgnment::maymot,be'approved. 'Seé"regulations at ,:;4:i(:G~Gl\Qµp$tßl00:';and¡>32,OO, ~r ~'~t,t:¥i~;' ',~~:~t~ Tear ,,' ''fear;' . . Tear .- - - --- - -''':':;;''':''''_.~'~-',-:,,:,- - -'--"-:'---'-'~-'~-'- --'--="--~-- - - -- - - --- '. ....,,,..... .."...,. Part A (Continued):' 'ADDmONAL SPACE for Names and addresaes, ohdditionaLassignees'"in.ltem No.1, if needed, or foc Land Description in Item No.2, if needed. ". .' ...,. -¡-.:, . '~..,:~.-1'".:.~'¡..~ :.:',. ::'J';,¡"",':~r',i,t"::,, <:":'~;: '.:;}"I,~, ~~J-.::__.._:".. ........ '_pO '1".." "I '.. '.··,·,...;.......i"·,·..'<.....· PARTS: CERTIFICATION AND <REQUEST FOR APPROVAL 1. T¡e AssIgn or certi nes.as owner ·,f a ~ in tcrest i n..tlie a bovedc:~igÌlatcd .lease th at hefsbe hereby assi,gns to the above as~i.gnee{s) the righ ts speciCíedabove. 2" Ai,ssignc~ certifies as folIows: (a),Assignee' is a citizen of the, United States; an assoC(Ïation of such,citizens; a mun icipalily; or a corporation organized under th~ liws'o[.,the' Un ited Sta,tes.orof any'Sta le ,or territory,thercof.,for tbe,a.ssignment of1~PR-A leases",assignee is a citizen, national, or 'r~sident alien, of the United S;tates"o,f,assoei.,tion,o{"sIlCh:citizens, nationals"resident aliens..o,r private"pllblic or',municipal ('o(,porations, (b) Assignee is not, considered a minor.under tbt laws:oLÌhe,StateJnwh:ich,the)ands:cj)vered bytbis,as~Jg.~,tI):7!l!,;pe located; (c) Assignee's chargeable interests, ,direct and indirect"i~ each public dOlllainud açqul¡'ed.-landS 'sep'aratelY.in·tlie'.s:ame:rStàte;',do'·not;,cxc.e~'240;()',80,:a,cres in:o.il. and ,gas leases.,(<?f wbkh Ilpeto 200~OOO acres may bein oil and gas 'options), 0.1 3PO,OOq;'acre.s..jn "leases'.!n each leasÎ'ng'DistncUn:':AlãsKit':.pt¡w.ti1ch',up'o 2~,(),;'OO0'acres may' be in.:,options, if this is an o.il a nL! gas le:a.sC'Ìssued"inaccord:anc. wÏ!1i the::-Mïri.erarLeas.ïÌlgAct.t1f.1920,.,or'Sil,;20'O.ea,cresJn anfo,ne SÚÚe ¡Uhis is, a g.~otbermal1c:a'se;'(d)'AlI. p:a.rlies holding all interest in·the assignmenl arc 0IherwiJ.~.'"ln'c.ol11:püa'l1cC',w,ith,the,regll¡'Hions',(.43:·eFR"Grou'p'3100'or 3200) 'and"lhe authorizlng Acts; '(e) Assignee iSln compliao'ce with reclam:a.tioÐ 'reqllj're~.~ß,,~:for,a.!I~I:',e1lJ:[aboil and.gas,lease:holdings, as. re,q,uired by sec.' 1.7.(g) of,the,Minerai' Leasing Act;, and (f) Assignee fS not In violation of sec. 41 of tho , '3,"" Mine ,~:'~¡~&f~~;;~:i~i~~~t~c~~~t~i~!t~1~~tiii;~tE1j¡i1t~~þÙ)~~'I:~'~~'2!;;â:~Q;f¡~~:~::::iI:i;:~:I~:;on~ and re~tricli~ns, pertaining to tb~ lease describe ., .... For ge0.lherma!..usi~~.me.nts, anove~iding,royallY' max IIOt be lessth"an.one-fO'Urlh'(lf4) of one percen" tof the, value of output; nor grca,ter than 50 ,percent of the rate c royalty'~ue:to, the,~:crn''itedStateswhen'lhis assign ment is added,to al~",prev,iou~ly ,:reatcd'ov~rriding royaHi~,{43CFR 3241), , . .. I certif)ì: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 fiiith. .~ J' .,.,~. ," ,'7' Ex~~~;~thi~ '~;6Jr day of ;;:¡- 6a.J,.A. '- ,~ Executed this .3· day of 'f '^^ '- .~200~ NameQ'f,Ass~gnor,as,shown on ,current .lease . " Please type, or 'print Â&si~~";~ ?~aU~igna~ ~'.',' Frank A. Mau ~rY~.~ or . .Attomey,.in~fact k ~ (Signature) Attorney-in~fact 2ß165 (Signature) preakness Drive (Assignor's Address) '-, Oaks Ranch,.TZ; 78015 (City) (S,tate) (Signature) ,.~,~ ~.; tpAlJ.~ .._,- -'~~--";'''''----'':'~~''~=''''~'':''''"';~- _."'-~ FaiJ; " ,."'" "'~' . '", (4~:,f,qct~) ~\:-/ ~~\,....,.c. . :",',n :<:::' -'~'",,:':~: "".'-; .-. I: "-;' ~: Public ~porting bu:de':l for this form i~estimat~d to avemge 30 minutes per response including the time for r~viewing 'iustructions gathering and . t '. d complenng and revtewtng"th,e fonn. Direct comments regarding Iheburden estimate or ,any other, as e.ctof this form to, US D' , ' ' m~n ammg ata, ani Manag~ment( I O()4,.003,4), Bureau Cleamnce Officer . {WO-63'Q),~ajf Stop4011S, '1849~c:.stI:èet; \hl7æ.:, WaShington, D.C. i0240~Partment of the, In tenor; Bureau, of Lan, ':1 Title,18·UJ.:S,.c.Sec..,.lOO~ makes itacrirndor any person lcnowingly. and willfully lornake'to:any.iÐepartment or agency of the United States anÿ false fi titi ftaud I statcments'or representauons as to' any matter within its jurisdiction. ' ,,' , IC ous or u eI ~ NOTARY ACKNOWLEDGMENT The State of Wyoming ) County of Sweetwater : ss. ) \..00025 Frank A. Mau, as Assignor, and Bryan A. Mau, as Assignee, who proved to me on the basis of satisfactory evidence to be the persons whose names are subscribed to the attached instrument and further who acknowledged to me that they executed the same on June 3,2008. Witness my hand and official seal. My commission expires: August 1,2009 MY COMMISSION EXPIRES AUGUST 1, 2009 .........."*"'...-..........._~'"....._"""..P,.,........~ STATE OF WYOMING ~-"''''''''-'''''''-~",,".~~k>''......rwJ'~ THEDAA.PORTER-Nê)TÃRYPUBL~ COUNTY OF SlJ\lEElWATER