HomeMy WebLinkAbout939741
Form 3000-3
(January 1999)
"J1NlTED,SIATES
DEPARTMENI: OF . THE INTERIOR
BUREAHtOF LANJ;kßAN"A6;EMENT
PORMAPPROVED
OMB NO. 1004-0034
Expires: December31,.200J
AS~IG.NMENT":OFRECORD TITLE INTEREST IN..A
LEASE,FOR:OIC,AND::GAS OR 'GEOTHERMAL RESOURCES
Lease Serial No.
W 71772
L'OC026
Mineral,Leasing.Act of 1920(30 U.S.C. 181et seq.)
Act fòr Acq1iiredLands of 1947 (30 U.S.C. 351-359)
", peothermàlSteamAct of1970(30:U~s~C. 1001-1025)
Departmentof:1:he"Infe:ri:6r"AppropriatioDS Act,,';Fiscal,Year 1981 {42' U:S.C. 6508)
Lease Effective Date
(Anniversary Date)
06/01/51
"'N~w Serial"No.
Type orprintpl.aihlY InlllÍk:;:and'.slgn In'lnk.
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1. Assignee'll Bryan A. Mau
S~t 7437 Dallas Drive
City, State, ZIP Code . Austin, TX 78729
'PAiRT'k ASSIGNMENT
*If more than one assignee, check 'here 0 and list the namè(i;) aDd addXess(es)'7ôrãIl adllitionâl' assi~ees on, 1fÌe:reverse:o'fthis form or on a
separate attached sheet of paper. . , . ,. , ", ' . ' ",', '"
This record title aSsignment is for: (Check one) Ix] Oil and,·GasLease;or 0 Geothermal,Lease
. Interest conveYed: (Check one or both, asappr;priäte')'!i~rRecorã'TìtJ.~, G8':Oiri:didkgR~Ya:lty, paYment out of, production or other similar ,
2. ThiS assignment, conve ", s !tliê¡<f6nbwÚ!'~1µi~'t~šf:t,.::?::"(::,,,.' ,
. 'Land,:~c~, tìþµ';,;,; ''':,',., /,:. ',iJ., ",::,~", ,'.:." 0, ;~ ;!>;,:/: ':;;¡(:}Rero.élÌœot:iiliìïterest~)"'¡l¡/''''''~: :i¡':~'.~~::"'~f:f'B~r!!nfJ,()U::':;;':"-',
Additional space on reverse,' if necdcd.Do'not:sul:imibdbc'6ìD:èiífSidr;;àgreêui6nts:8llier'tlliuì¿. '1' ,"bWn&í: ',;' r:'t:bnvcyéd';:~" !kJ&iieä",! :''''.~~eî\tïâ§:ii~Q~,!illÿ' .
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,l'CSCl'Vcd
or'conveyed
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Township 22 North, Range 112 West, 6th P.M ~.3125 .3125 None
Section 10: S 1/2
Section 20: W.1/2 W 1/2; NE 1/4 NW 1/4;
N 1/2 NE 1/4
Section 21: N 1/2 N 1/2
Lincoln County, Wyoming
Containing 760 acres, 'more or less
Z- 1/
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RECEIVED 6/13/2008 at 10:16 AM
RECEIVING # 939741
BOOK: 697 PAGE: 26
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
FOR:(~~t!M';:US'E~:Ofll.~Y~'~9.:::~,~:t,W~IJ.E\;BEI.OW THIS LINE
, ": ';'~uNî¡ihU:!S1;X;r.EStt>R:~CA,
This assignment is approved solely. for administrative purpoSes. Approval'does not warrant that either party (0 this asSignment holds legal or
equitable titIe"to·~lease.
'0 Assìgnrnent.approved for above described "lands; 0 Assignment'approved for attached land description
Assignment approved effective
o Assignment approved for land description indicated on reverse
of this form.
By
(Authorized Officer)
"'.
'.
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(Title)
(Date)
Tear PART C:GENERAL INSTRUCTIONS Tear
1. Assignorl Assìgnec(s),must complete ,P.arts,AL8Ild A2, 8IldParHL,Au','partiesto 5.., If anYiMyment<out ,o!,production or similar interests, arrangements or payments
assignment must'Šign,asfOllows::The,assi&nor(s)",mus!.I)J3II~~;S.igp.(:@'.Or;igïnaI, , .,havc:previouslydJeeniCI'Caœ-d,?oUMfjthe,futerest1beingrassigned,..or_ü.any. ,such,
copies and tile assignee(:i)'must'm.ariuallysign 'at least }:oflliei3'örigIDalcopies. J)aYme~¡OI:jntcrests:,are~""t;y¢'UDderithis\'8SSj~;"¡ncludc"a.t~gìving
File three (3) completedcopics .of.tbis.:form.in. thcproper.rBI.:o¥,ofi?c.eÆor;each fulIddài1sas fo'amount,IIiëtlïo\:rOfpayment, a'nd'otherpertincnt terms as provided
assignment of recorcÌ'title. For a transfer of:overridiIig;roylûtyfuteres~ .payment ,: undex:::43¡C}1R;31Q6¿3135,~.,or;i:3241.
out of production or, othe.r similadntcrcst OT.,paymcp.t,file\one,(l)cIi1anuillysìgned 6. ':rhcdeasc' !lCcount-mIust'1Ðe~iiì!.good"staniling~bcfore.thisc,assignmeilt. di.n' be a.p-
copy of this. form. Thc'rcquired: filing:.fee· (nonrcfuD:P,ablc};must-~omp.any,:the.",proVed"as"prOvided'l\1Ilder:.4g·',CFR:3 1(6)/ \1ld't324L ,
assignment. File. assignmcnt within ninety" Ç90) ,days after..datc¡ of ,execution..of,· 7. Assignment, ìfapproved, takes' effect on the firstday;of tI:Je month following the
assìgnOr·d&'1>'tiñlingiii~llie.':Þr'~!J3l!'M\Ôffii:e'.'If'a~bòrid is neces~'r .i,t,,~~ ÞC: fur-
2.Separau: forrnmustbe used for each lease being affected,bythis:assignment and ·;iüshbií.1titibi'.:td:'¡¡PP~âli'dfVffiC'.~assígritnCÜt. .,'. ',',' ",,", "
for each, type of intr;¡"estconveyed. , , ' , ' 8.App'r,:qv~'o(assì~nt>çf;~,o~;pt1c,to.lp<:19G.'O(~)~0'i1~t}he>;J.~:~
3. Indtcm'No.' '2' ôU'artA" de3Cribe:landsó!iffected;(Sœ'43' CFR''3'I06'/ala5i;;or.~'~'ea.2.Ù¡fffiërd'irine:d~ändtbe'aSSi~}Xílti9,iïS;)ïUt;&êii,~rJiR?gc
3241).,. Fór,columns;b, c;-d"and 'c; ·,cntett.thc':mterest"cXpressecfiaS"jl':p¿rccntagc .tliê"'tê~~íci~fcòndÎfi6Iisidtihb :rëåSe:antÎiv~:(f;¡ëfofpÍÎrpoš6afpaiirient
of.totalintcrest,fu the,leasc;.'c.g.,if:assignor,cassignsone,quarter·ofJf20,%"in_Of 'annua.1,.rental" . ., '.
tercst".cntcr .zŒ%in.column"b,5 % ,in column 'é; and :IS % in column 'd. 9~ 'Oveci~g:ñ,yäItY;~~tout'öfpioductiono; othé~sì1tli1ar~oftransfers
4. If assÌgnment;iS,tomore ,than 'one .assîgnee"entereadL'assÌgneè~s·namC'across ,mustbe.fi1ed,with BLM, but will bcacccpted for record purposes'oIily: No offi-
,columns,d,;e,andfnextto,the respectivc'intcrestbcin~¡conveved_,Al (\ H><tTUlTne.. ..e, ""'-~__..,,_.,,' ,. '
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P APERW9RK .REDT1f"''T'T....lI.T ~C¡,S1'ATE~NJ'
] . This.·infonn¡ttÌon i.., _ ~__" _ _~ected plIrsuanNo;,the law,
2. This!infonnation'wiU bc'used,to create and, maintaiJ1' a'record of "oiL and,
g~/g~o.t):1e~Jease.activity. .
3 ,.R~{Ié1l.$.e,tQ,4ris·n;q~est¡js: required to"obtain ,benefit. ,'d ,":"!'i1~,;~'
BLM!w,o:uId:'like'yoU'\t9l'kno:w that\ you do not 'have to respond tò:tlÜš!briari)fi:¡'th~r¡
Fedðra:L~gj::ncý spopsored~infonnation collection; unless' it.display.s;:a;currently'
vali~Q~':P?l1~l',numi?,e~. .
NOTICE-
The:}>,ri.v.acy,A~~'Qf;,1974;;m4,¡\1e..¡;egula.ti,Qn,~^1~-Ç1µt:2A3(ø.),¡prp:!{.ilt~tl¡,¡¡'F~y,,9l\~þe:
fu.t;l},iSfie4~fu~i:±:¿Jî!?"ì\d~~in~~~pn.in.conn~Qtl,Wjth~inf~~tion'~9¥~~d."J.Y.¡\tbis
oil,.and:;~~~fl,~?tþ~~J:e~~rd,t1tIe, asslgnrnent,~:.pp~(;atiQIl":.';':'~';~.,,~',";"~:;::'
Au.rH.0~;'3.o'¡'U:S:t: ,18l'et..seq; 30U .S.Ç,...lQP J;,,,,10+5.;.42,.U,;~;.q~:~6~,08:
·':·:·.,..,:.~;:~,~~··::::~'~:·,~:~""cò~-.~:.~. oiL'.;" .\..... _ ;. \",;:'" ," ·.~':;::7, .......,..~~;:;,\~.,.~..
p~ÇIPAL, F~0.§~~e,jjnfor¡:nan:Qn.is",to,~be.us~:~0!.pfQ9\e~s.recDrd:,tit!l:!,as-
signments;fo¡:<Q.il,!nd~~geo.th.~ãI;,x:esources leasl::s. ",
'ROUTINE.·USES:,
(OC027
. .. ..... .
d(l)1J¡e,a\ÿuØicationof the assignee's rights to the land or resources.
. ·/i.':':·'''':·~·'''·'.·~.x.''i''~: .
,~~ior.-publicinfQImiltion in support of nota~ODSmaœ on;land,S1atus
,'Co:manag,ement, disposal, and use of public lands andrescurœs.
". ""·'il.Y;~,~-: ..~..
',iiâi:ø'l1¢eral agencies when concurrence is required prior to
'1$:~¡j1i~llands',or resources.
;'<4!){5)'~f.ormatioll;\f¡¡9m¡,the,recordandlor'the·record will be transferred to appropri-
,latç:£ìc:deral$'St<lteiflQqillor, foreign'agencies,when're1evant to 'civil, criminal: or reguIa-
','to,x,i....m.vesti~öns.JQr¡prosecutioDS.
;~~;~;J~~~:;~~í;·;~~~~!~::;~!~;·· . .
.. ,',' ",.,~N,U)JNGIl"!/EØRMABON-If,alkrequested'informa_
@.~i~\~tíÏiwasSignment::\ßl8y:m,otbe'approv.ed~ 'See"regulations at
M~p's~3l00;;and~\3200~ ,
."......
Teat "-Tear" . Tear
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Part A (Continued):' 'ADDmONAL SPACE for Names andaddress.esofadditionaLassignees,in,Item No. I, if needed, or foe Land Description in Item No.2, if
needed.
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PART B: CERTIFlCATIQN AND 'REQUEST FOR APPROVAL
, ,
1. The A~~.ígnor cerlifies.as owner .,( a~ in Icrest in.the abovedes.ignated.Iease that he/she hereby assigns to Ihe above as~i.gnee(s) the rights specified above.
2., Atssignc.e certifies as follows: (a). Assignee' is a citizen of the,United Slales;, an assoc}alion of such ,citizens; a municipality; or a corporation organized'undèr tb~
I~ws' of,the,Uniled Sta.tes.or,of any'Sta Ie ,or lerritorythereof.For the,a,ssignmen t oC1~PR-A leases,,¡assignce is a citizen, national, or T.esident alien, orlhe United
S:lales,orassocia,tion'Qf:such:cilizens, nalio.nals"resident aHens:,o,r privale.,publie or'municipal oorporations, (b) Assignee is not,co,nsidered a minor,ullder the
laws:o.rlhe.Slate.in:wh:i.ch'lhe.]ands:c?Ver~d b~.this,a~}.g,!1:m,~.G~:;¡a.relocated; ·(c) Assignee's chargeable interests, ,direct and indirect,:i~ eacb.public domaÍlulnd
a~qu:¡Ì"ed,.landssep'aratelÿ.in'the'same!Stàte:..,do"not¡.excee.d:;24'i5;'0',8O'.'acres in;o,i! and..gas leases.,(¡Jf whic.h up,·to 20'0':,0'0'0' aC,res may be in oil and gas 'options), or
:WO,O'a'~'acre.s"jn "IeasesJn eaclr leasJng'Districtii{AJãs¡¿~;'.ofíW.li:ic!Ì.::1iJi'lo 20''0;0'0'0'' acres may' be ¡n,:options, ifthis is an oil and gas lease'issued"in'aecordance
wnti lhei?Mïli.eran.easJng Act o(1920"cod;:l,,2O:Q:'a,~iei;¡n anfo,ne Stit:le iLiitis is, a g,~othermallease;' (d):AII, parli~s holding a n in terest ¡D"the assignmut are
olherw~t,~,in' cO~RÜanC6',w,ilh.tbe,reguIM'ions:,(,4:3"OFR"Gro·u·p·3100"or 3200')and"tlte authorizing Acts; -(e) Assignee iSln complian'ce with reclamation'
·r~~uj"ie~~~IS::;[or,a.,!,I::I:,eaerabQi¡'and:gas:lease"h,oJd.ings, asrc.q,uired by sec.' 11(g) ofllte.MineraJ Leasing Act;.and (f) Assignee is nOI in violation of sec_ 41 of the
3. ';i~' . ·;t~f¡¡i¡¡'<&<ó~, ,';~~1\¡;¡;,1~J¡¡¡,;:~¡¡!¡{;:!.f,;'1¿;oo; "d ";'o,,'ó,, POI'" .¡.g ~ ,,~ I~~ '=rib"
h ercfn,.,
1'. .,
For g,eo:~herma!.:a:>sj~,nments, an ov.e¡;riding,royalty ma~ IIOt be less, than'ooe-fo'urth '(1/4) of onè percent,of the value of output; oor grca,ter Ihan sa percent of the rate of
royalty'þue;ro, the,:JJniledStates:whcn, Ihis assign ment, is added, toall::previously 'c.reatcdoverridiog roya,[ties}43 CFR 3241). ,
I certify.,that·the· statements made herem by' me are true, complete" and correct to the best of my knowledge and belief and are made in good faith.
Execut;';tþj:"ÇJy d
day of ~ IJ...L-
,X'K 200.f'
Executed this
,~
day of j "^^ q
,~2 0 oC-¿
.:"j\~ '.
. Frank A. Mau
Nameqf,Asslgl10r,asshown on,current.lease ,
ÂssiY.n~/j).J; ~ (f1- ~~se typeor~rùxt "
or . ~Fr.a:nk A. Ma u (Signature) -.'
Attorne.y-in~fact
~. '~~"Mã . A- !\-
, or Bry J au (Signature)
Attorneý:-in"fact
(Signature)
2ß165
(SigtJatlJre )
Preakness Drive
(AJisignor'sAddress)., '
Oaks Ranch". T~ 78015
(City) ,@ató)
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PUbli~ t~porting bu~de~ for this fonn i~estímat~d to average .30 núnute:s per re;;ponse including the time for r~viewing 'instructions, gathering and maintaining data, and
~mp eting an(d10r;"jIoew03ID4)g\'Bthe fonn. Dmct comments regarqt,ng theburde, n, estimate or "any other, aspe.c, tof this fonn to, U.S. Department of the Interior Bureau of Land
anagement V'1:' ,,' ureau Cleamnce Officer ,(WO-63Q)JMairStop.4011.s,1849iC.StI;êet;¡N~W;, WaShington, D.C. 20240. .
"
TitIe;l8'1lT;S,C;Sec_',lOO~ ~akes ita crirne for any person knowingly. and willfully to,make'to'anx~Ðepartrnent or agency of the UIÙted States any false fictitious or ftaudulent
statements or representations as to. any matter with~its jurisdiction. '" ,
NOTARY ACKNOWLEDGMENT
\..OC028
The State of Wyoming )
: ss.
County of Sweetwater )
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.
'I.
My commission expires: August 1,2009
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THEDAA. PORTER - NOTÅRy"puàüë-
COUNTY OF STATE OF
SWEETWATER WYOMING
MY COMMISSION EXPIRES AUGUST 1. 2009
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