HomeMy WebLinkAbout939744
Form 3000-3
(January 1999)
"UNITED' STATES
DEPARTMENI: OF'THEINTERIOR
BUREAU!OF'LAND"MÄNAG;EMENT
FORM APPROVED
OMB NO. 1004-0034
Expires: December 31,2001
ASSIGNMENJ,:QFRECORD rlTLE INTEREST IN..A
LEASE.FOROIL,:i~ND~GAS OR GEOtHERMAL RESOURCES
,}OC035
..
Mineral Leasing. Act of 1920 (30 U.S.C. 181et seq.)
Act for AcqUired LandS of 1947 (30 U.S.C. 351-359)
.peothermalSteam.Act of1970 (30U.S~C. 1001-1025)
Departtnentofth~'Il1teti:dr·Appropriations Act,,"PiscalYear 1981 (42'U.S.C. 6508)
Lease Serial No.
W 05925
Lease Effective Date
(Anniversary Date)
06/01/51
';New Serial.No.
Type orprinfpJ:aihlyln Inkt:andslgn ¡nlnk.
"
.'. ,;;-.
PA:RTA: ASSIGNMENT
1. Assignee'" Bryan A. Mau
S~t 7437 Dallas Drive
City, State, ZIP Code, Austin, TX 78729
"'If more thaî1 one assignee, check here"O'and'list' the name(s)åridaddiess(ðSrônIl additioIUÙ'assig~eeson the reverse Of thìs form, or on ,a
separate attached sheet of paper; , ,," " , , , "
TIùs record title aSsignment is for: (CJu:ck one) o Oil andüasLease, or 0 GeothermalLease
2. ThiS assi
:==~:='':<;i~=:=y~~,~t~,;",o,.~~#fuo<"",:::",~~:~";:r;~:S~·,
, ". ~~.~'. ,. ," '''',1.:
.Rescrved",:~viously ,
:reserved
or:conveyed '
f
....
a
,b
c
d
e
Township 22 North, Range 112 West, 6th P.M.~~.3125
Section 26: W 1/2; N 1/2 SE 1/4;
SW 1/4 SE 1/4
Section 28: E 1/2; E 1/2 W 1/2; SW 1/4
NW 1/4; W 1/2 SW 1/4
Lincoln County, Wyoming
Containing 1,040 acres, more or less
~, }/
.3125. None
~
t'.?
Z Þ 't RECEIVED 6/13/2008 at 10:24 AM
RECEIVING # 939744
BOOK: 697 PAGE: 35
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
,.FOR:aLiM';US'E;ON,lY-';·DQ,'fNPJ.WRITE0BELOW THIS LINE
, '·:(JNrirEDZS1:'A:r.Esf:OP,'AMER:rCA
This assignment is approved soJely. foradministratlvepurpoSes. Approval'does not warrant that either party ~o this assignment' holds legal or
equitable titletoth!slease.
o Assignment approved for above described lands; 0 Assignmeritapproved for attached land description
Assignment approved, effective
o Assignment approved for land description indicated on reverse
of this form.
By
(Authorized Officer)
(Title)
(Date)
-. - ~ ~. -
·W ".._. ..... ._.
... _. M "_ _ _ __' _ ø_ .._ __ _.. ~_ ._. _ _ _ _
-~. _.-
Tear PART C:G'ENERAL INSTRUCTIONS Tear
1. Assignor/Assìgnee(s),must completePartsALan4 A2 and Part B., All parnes to 5.., If any¡paymcnt!Out ,ofproduClion'or símiIar interests, arrangements or payments
assignment must :šign;as folIow,s~:The,assignor(s) mus~man\l!illy+sigp.',3,orjginaI." ,have,previouslyd)(:en(created(¡out"ofithe.~ten:st'.'being':assigned'"or"4f 1IIlY, '~s~ch,
copics and the assignee(s) mustmanu.aIIysign at least: LoftheJ Originalcopies.pa}'IDCl1ts;orin~,are.~¢~this''IIJIRIgJ1",..-'1t;'~de>a¡~g1~
File three (3) complctedcopics,ofthis,form.iIL thepropc¡:,BL1I:[,ofqccJor:cach fuIldetaiIsas to'amount"methodofpaymcnt, aml'othcrpcrtillcnt tcrmsas provl(lCd
assignment of tecordûtIe. For a transfer of:overridfug.,royáltyihtdest; ,payment under J3 rCFR,3106,' 313;5" ,or,13241.
out of production orothei- similar,interest or,pa}'IDCIlt,fiIe,onc(l).manuaIIy signed, 6. Thedeasc' account-,must',be"m*good'standìng¡'before this'aSsìgnment'can' be ap-
copy of this,form. The required: filing"fcc ,(nonrefundablc:}must·¡¡¡:company1he'prO'ied:'as"provide¡bunder43·:CFR:3100"l\I1d"324L
assignment. File, assignment within ninety ,,(90) ,days aftcf,datc, öf,execution,oi, 7. Assignment, if approved, takcs'cffecton the first day:of the month following the
assignor·date''Of;:fiÍìngìÏ1·tìi.e.'P~'BLM~OffiCê.Ifabönd isnccessary', it mnstbc fur-
2. Separau: form must be used for each lease being affected by this assignment andiilishi:iifpriör"w'_åi"<ifthê.:assígnmènt. ",' .,,,, ' "
for, each, type of intçrestconvcyed. , 8. ,Appt:o.val.of lISIIignmcnt,of;~r4;,title:to IIJ9<¡¡;of'a:~~nof"tIJc"t~~lands
3. InItem 'No. 2 of Part . A, describe:lands¡àffected (SecA3 CFRi'3106,"3135¡or '~:sépaiate']easesÒ(ffierêl.åÍD&tand thc~@e'd,Ix,!iti~,bUr~~t;bangc
324 t)., Forcolumns,b, ci,d" and"e, entertthe:mtercst'exprèssedtaS,a:pcrcentagethe;ìirms'imaconditions 'of iliê .ICaSe'amiivcrsàIydãtC'.foÌ"purpose!l ofpaytnent
oitata! ,intercstin thdcase;,·e.g., jhssignOl~.assignsone, quarterofa 20% in- of annual,rental. , . , '
tercst,. enter 20:% in. column"b, 5 %m column c; and 15 % in columnd. 9~Overriwrig'roYálty ,pay~nt out'ofpiOOuctionor othersinillàrtypesof transfers
4. If assignment"is to more ,than 'ODe ,assigncc"ènter.eaclFassigncc's'name across mustbc:.;fiIedwith BLM, but will bcaccepted for record purposesoliIy; No offi-
, columnsd, ,e, and.f next tothc respective interest being,conveyed. Al~ list D81IICSciäI approval' will be given.
and addresses of any. additional assignee(s) onreversc ofthis form or ona scpara~
...&4._,_L_..:] _1..__... .....:r.._____
PAPERWORK REI .¡\.C;r.s:rATEM,ENT
]. This.Jnfomw.t1OD IS, be.I,Ilg,colJected pursuanto.to¡the law.
2. This1infoITl1ation'wilf be,'used,to create and, maintain' a',recordof:oiLand
g~/grQt;hermar lease. acd vi ty.
3. ,:~p,Òn$e,to.:Í):ús~ql1est,is: required to,:obtain ,benefit" , ,c,! <"",tr1;~ ':::"
BLM·,w.QWd:]ike'you~t01<knOw than you do not 'have' to respond tô'tfiiš,iof.ariYfò1ñèft
FederaLlIg~ncÿ spqnsored~infonnation collection: unless it,displays::a~currentlÿ'
vali~Q¥Bi;C?-p''!.:?hlUml¡~., ..' '
. .! - ...... ,·:·i-:,}.;·.\'~~ ..." ,>":"..
NOnCE'
Th~,.Pri..v~~y,.Ac,~i9f:AQ74'!U19¡~e,œgulatipn, iq.4~·ÇF,R'~·48@'i?rpXi¡j.~~.9l\\1~:'
fum,i$h~'~,J.å¡~9>'IY~~~pn,in.COJlnec:üQll;,with~'1Uf~~tion~9¥:~,~~~this
oil:.and:,g¡¡~~otJ1.,~~J!;IISe~,~ecordtltIe-,asslgnment,ap'pli,(; lùQn.. ".. ... ·,,,n":.'
.. _ "i ....:..,~:'.;.. .>;'':.-,¥''
AUTH,9~~·3.0:"iæ:s~E JÛ;et.seq; 30U .S.C..lOÓ~.'i~~~;42,:U~S:.g~:Þ?Q8:
~:'.' . ;'":.:\'~;~': "~;~~;':J~~.~tt:;:~"-:.:.-, -~~" . I .. _.:. ~. \. -,,, ';.;~~~' " ,::~.~~;~"'- ,~,
PRINçreAL.P~§~~;jnfo~Qn:,is,to;,be',u~:~()t,p~~s"recO!(ttit!r.'as-
sigpmen(s:forÁo.il~d;~~ge~~~ources,leascs. "
R0UTJllŒ.,USES:,
(\OC036
d(1)1;I:Iec:~ué£l!:tionof the assigncc'srights to the land or resources.
. it ~'.'" ",:': ',;', ....~:~"~' ,
,-::1. f"......\o1~.~({.« :~. , .
Cf}~mre' ". . JtfòrpubJicinformatio~ in support of notations.!118de oD,land;status
"'.'~rFco", " ,~j¡riana&ement, disposal, and use of public lands and.resources.
." '. - . '"<.'" ,. ';
'F,¢era1 agencies when concurrence is required prior to
'ü¿i!lands'or resources.
;(~5}.Infp1'll.1Rtiolg,f¡¡<?míthe,recordandlor,1:he'record will be transferred to appropri-
:'at!::Æì~i¡,'St¡¡teïfIQciillorforeign'agencies,when'relevant to'çivil, criminal' or regula-
to~&'{ '. n.s.:!~,P'J?!Osc:cutions.
,~:!jiV~'i~,t. ;<~i:",ii:;,0 ':
Teai'
.------ - - ......:....;-~,:-.~--',~- - - --"-'-'--"_:~-'~'-'- --'---:------ - - -- - - ---
Tear
.;'.,",. "",;,,,.\',,,, ,-........,.. h
Part A (Continued): 'ADDmONAL SPACE for Names andaddressesof:additi~naLassignees',in,Item No. I, if needed, or fOl Land Description in Item No.2, if
needed.
". :..I·~ . . ¡~: ;
'i-.
.,."
'1;'
."~ ~J.';',:.~'i.;..'.:":_..
..
.....;"...~' . ,
,\
,
1
PART B: CERTIFICAT:lONAND'REQUEST FOR APPROVAL
2..
1. The AssIgnor certifies.as owner ·,f a~ Inlerest in.the aboved~~ignated.lease Ihat lu:/sbe hereby assigns 10 the above as~i,gnee.(s) the rights specified above.
A:ssigne~ certifies as follows~, (a),Assignee' is a citizen ofthe,Uniled.$la les;, an assoe¡ialion oCsuch ,cilizens; a mun icipality; or a corporation organized under the
l~ws'of"lhe' Un ited Sta,tes,or of anyBta Ie or territorytherc:of.·For Ibe.a.ssignmen I oC:NPR-A leases,,;assignee is a citizen, national. or 'r.esident alien, of the United
States'o,f.:associ,'!ion,Qf"such' citizens, nalionals, ,resident aHens;.or privalc"public or',municipal cOrporations, (b) Assignee is not.considered a minor,under Ih.
laws:oCÌJ¡e,Sta lein:wh:l.ch'lhe:l~nds~c:c;>vered by:,lhis,asI¡J&~.II):~~1,)~e located; ,(c) Assignee's charge2ble in leresIs, ,direct and indirect, il). each public dOlll2inud
2fQu'ired,landS 'separatelÿ.in' Ilíe.same1Stàte:.do·'nol',cxcee .~'2~i)~(»aO:a,cre$ in:,o,il and,gas leases..«)Cwhic.h up'to 200.,000 acres may bein oil and gas'op!ions), 01
3PO,OO'Q:'acre.s'·Jn '.¡'eàj¡es'.Ín each leas,i1ig'Disirictin:\ó,'lâslla:;Þf::.w.li1cb',ù,p"!O 20'0';'000' acres may' be in,:options, ifthis is an oil a nü gas lease'issued'inaccordanc(
with !h~:Mj'lierarLe2sïi1gActÐ('192Q,.0r'5il,;20:¡!.'a"res;¡n anfo,o,e St:Úe ¡Cibis is, a g,eothermal k2'Sej' (d) All, parties holding an interest in "the assignmen't u(
01h,erw:~¡;.~'..in,colllp'üa:nce'.w,ith"the·,regulM'ions{43:'CFR:-'Grou'p'3100"or 3200)and"th'e authorizing Acts; '(e) Assignee kin compli2D'ce with recl2m21ioa
'requ:ìre~~n.,IS:(.or,aJI::'I:,ê(k(al'QiLand:gas, leue'·hold.1ngs as,re.q,llired by. sec.' 1.7(g) of.theMineral' tusing Act;,and (f) Assignee rs not in violation of sec. 41 oC th,
,,;:.~~;,[~e.' . 'L.':,:::¡::iGr,:~~:¡~'::;;. .,,: :;:k%{I%:J;';t.:;¡:k~;;'S;:;.~{:;\,;;i:~:;;''',::;;::;·'·'::.'.:!~¡~;:;~~(:~;:~::~:"':;~,'::,;>;:': ',. .' '
3. 1'.</, , "ïS:ias'srgiimêlÌ'{consi'(t)l:(è:s'â'cë:è'pt~.j¡.6.Oiiót~a:lfRp:þIia~b.lete'rm~;con·d'itions, s'tipùlâtions and restrictions, pertaining to the le2se describe<
,her"fn.,
t':.
". -." "~':-'
For geoih"rma:!...assÎI¡:..nments"an oveJ;Tidlng.royalty'max not be less thao'ooe-Co'urth'(1/4) oCone percent,of the value of output; nor grea.ter Ihan 50 percent,oC Ihe: Tate 0
royaItY'~ue:to the;:tJri'ited'St2teswhen,lhis assign m~nt is 2dded,to al~:,previoll~ly ,c.re2lcdoverriding roy.a:lties..{43 eFR 3241). ,
'~'J~" . _~',\"'!.
day of J(.\A '\.
I certi~,that'the' statements made herem by' me are true, complete" and correct to t,he best of my knowledge and belief and .are made in good faith.
\5
,~200~
~'~(5
,~
Execú~tI~this
Frank A.
Mau
Name, Qf,Assignor, as 'shown on ,current.1e¡¡se
'...^ ..,'~ '.,¡";\ '. "Z.u ~ P~, e type, ,_or'p"",~n, t, '
~ip~;""'~ ~ '~ ~ -
or 'Frank A. Ma u (Signature)
Attorney-in-fact
2~165
(Signature)
preakness Drive
(Assignor's' Address) ,:;",...
Oaks Ranch,.T}{; 78015
(City) <State)
(4P.·/~~~)
,:".'"..,..¡
Fai:r;:-
'.,..,
day of ~ '^^-~
EXCCIlted this
"'"-a,:yR ~
or
Attorneý7in"fact
ft.^--
(Signature)
(Signature)
&MfJ~J
.. .,."',·"-·=-""'--0:-_7":",,,"'......,=,,,=,..=.;'..=:;=·0.' ".~,."""
c.:·,.....) ~~ ;:'.CJ ~.:.'~· ::11
\\ ',:=~..'~·,·.;··>:.:cn è:~~:[ê3
0,," ,.,,:'::,:
~.~ .,: i<.
Public r~porting bu:de':1 for this fonn i~estimat~d to average 30 minutes per response including the time for Jviewing'instructions gathering and maintai i d t d
completmg and reVlewmg, tb,e fonn. Direct cosrunents regarding the ,burden estimate or ,any other aspect. of this fOITl1 to, U S De . e f th ' . n ng a a, an
Management (1004,.0034),Bureau Cleamnce Officer, (WO-63'0)JMairStop,,40 LLS,1849'C:.Strè'et; ibt:w:,' Washington, D.C. 20240. partrn nt 0, e lntenor; Bure.au of Land
,
Title :1811T:S,C~Sec,',100~ makes itacrime'for any person knowingly. and, willfully to,rnake'to¡anj\iDepartrnent or agency of the United States any false fictitious 0 ftaudul t
statements or representations as to any matter within its jurisdiction. ,,' ,r en
NOTARY ACKNOWLEDGMENT
L'OC037
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.
My commission expires: August 1, 2009
J.~""""A"~Y"""'''''''''~·''''''l'\''''~''''I/IIw/''''~_
THEDAA.PORTER-NOTA~puãL~
COUNTY OF STATE OF
8WEE1WATER WYOMING
MY COMMISSION EXPIRES AUGUST 1. 2009
~~~~~~~~~~~~-