HomeMy WebLinkAbout939746
Form 3000-3
(January 1999)
"J1NITED,STATES,
DEPARTMENI: OF THE INTERIOR
BUREAU<OF'LAND<MÄNAG:EMENT
FORM APPROVED
OMB NO. 1004-0034
Expires:, Decembedl,2001
A$SIGNMENT,:OFRECORD TITLE INTEREST rNA
LEASEFOROILAND,GAS OR GEOtHERMAL RESOURCES
Lease Serial No.
W 05924
Lease Effective Date
(Anniversary Date)
06/01/51
, New SeriaLNo.
L10C,038
Mineral Leasing. Act of 1920 (30 U.S.C. 181 etseq.)
Act for ACquired LandS of 1947 (30 D.S.C. 351-359)
. GeothermalSteamAct of1970 (30'U.S.C. 1001-1025)
Departmentohhe:Interior'Appropriations Act,;'PiscalYear 1981 (42' U;S.C. 6508)
Type orprlnfpl.'8lhry In I nki'a nd sign Indlnk.
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1. Assignee* Bryan A. Mau
S~t 7437 Dallas Drive
City, State, ZIP Code , Au s tin, TX 7 8 7 2 9
PAiRTk ASSIGNMENT
*If more thailoneassignee, check hereDand'1ist . the name(s)aD:daddI'ess(6S)"ôr iilladditional'aSsig~eeson the reverse· of this form, or on a
separate attached sheetof'paper; '. ,," " ". "
This record title aSsignment is for: (Check one) Ii] , OiIandGas Lease; or 0 Geothermal Lease
Interest conveyed: (Check one or both, arappropriiite) '!*l'Recorä'Title, 83'bv~riidÎng Royalty, paYment out of production: or other similar ,
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ent ,conve
2. ThiS assi
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:Previously
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Township 22 North, Range 112 West, 6th
P.M.
Section 15: N 1/2 S1/2; SW 1/4 SW 1/4
Section 22: All
Section 26: NE 1/4
Lincoln County, Wyoming
Containing 1,000 acres, more or less
",.3125
.3125 None
/+
RECEIVED 6/13/2008 at 10:25 AM
RECEIVING # 939746
BOOK: 697 PAGE: 38
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
FORH::¡I1'M'US'E;O:N.l\Y~'D9.:NQj':WRI;rE0BELOW THIS LINE
, UNUED;S:t.ÄT-ESk p:~CA
This assignment is approved solely.foradministratlve purpoSes. Approval does not warrant that either party to this assignment holds legal or
equitable title to 'tl$ lease.
'0 Assigntnentapproved for above described lands; OAssignmeritapproved for attached land description
Assigmnent approv~ e7fective
o Assignmentappro:xedJor land description'indièated on reverse
of tliis form.
By
(Authorized Officer)
-. - - ¥. -
(Title)
'(Date)
Tear PART C:GENERAL INSTRUCTIONS Tear
1. Assignor/Assignee(s)"must complete.PllrtltALand).2, andPartB. An:partiesto s.. If any,paymcnt;outof'productiou'or sími1ar interests, ammgemcnts or payments
assignment must ,sign,88 fOllows:.The,assignor(s) mustman~,,~igp:¿tor;igiDa1 "'have,:pmviously::¡!Jeemcreated'lout':Of,the:ihtcrcst:beihg'assigned,or,df:'any:such
copies and the 88signce(3) must manUálly sign at least :LoftbeJ 'örigmalCopies. :payme¡rts'or,~,are'~J!Y~'onder.1his"ass¡.~'includc.a;stuleiDentigivÌng
File threc (3) completcdcopiesoftlùs.Jorm,in, theproper-BLI.'hofflccJor; each full dctai1sas to'3IIlOUIIt,IDèthodöfpaymcnt, andothcrpertincnt tcnnsas providCd
88signment of record title. For a transfer ot:ovenidùÌg;roYaltyfufeÌ"est;payment under 43 iCI'R.3106,,3135¡,or.i3241.
out of production or.othcÌ" similar,intcrest or.paYIDC!1~,ñl~,one (l)manwilly signed 6. Thedease· account"must':æ'1îhgOOd'standingtbcforethisqiSsignmcnt"ean' be ap-
copy .of tlùs. form. The required: filiDg.fce, (nonrefundJible),must'a¡;company:the, ",proved"8S',provided,:undCr43',: CFR:3106\'IID'd','324L
assignment. File assignment within ninety'(99) day,s afterfdatc:,òf,cxecution.of.· 7. ~ignmcnt. i!approved, ,takes'cffccton the firstdaYiof the monthfoll.owing the
assignor. ,dateuffiÎingfu-tlic.'prop¿r'BLM'office.Ifa'bOlld Î!I nc:cessarr, it"mustÞC fur-
2. Sepanu: form must be used for each lease being affcctcdbythisassignmcntand 'Iiishid':Pribi-'td"8pp'rèJtì\J.:'cifthê'wígmDéùt. '}<",.
f.or ,cachtypc of in~ conveyed. ',,' ", "" 8. Appr.qvaI .of assigm:¡u,:nt,.<?f;rccprd;?-tleto. l,~%,o(a.porti?naf.~;!,~sœJands
3. In,Iù:mNa. 2 oUart A, dC3ClÌbe lands'aifcctcd;(Sœ'43 CFRP3'W6',·'3135¡.or 'crcâteS'~~'leasesoftlìërêiäÌDe¡:i'andtheasSi~portio.iJS, ;I:Jirt'ÖOCSIlOtF,bw1ge
3241). Farcolunms:b, c"d, and"ð, entcr'ilie'inù:rest'cxpressd(frä8'a;pè'rceXitag~ 'th'é<Œtfus :ånêrC'ònditiolis'ofÌh~ leàSc'aniÏivêiSãiý,tbltC~fofpurposes ôfp:iyinent
oftotJÙihtcrcstin the'lease;;e.g.,if; assignof:assignsone,quartcrof a 20% in- ,of annu~l.,renta1.
terest" enter 20% in ,column'b, .5 % . in column c, and]5 % incolumnd. 9:Overriding:roYa1t;"~YDumtout'afpiôductionor other similár ty'pc$,of transfers
4. If assignmcnt;jsto 'm.ore than·one'88Signce,cnter,cachassigneè's'nameacross mustbc,µJ.c(Lwith BLM, but will bcaœeptod for record purposcs'only ¡ No offi-
' colunmsd, ,e" and! next to the rcspectiveihtercst being:conveyed.,~ list naJIlCSciâ1 approval' will be given.
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P AFERWORKREDTTC'mun,T \C;r.S:rATEM;ENJ'
1. 1'his.·infonn!ltlon i~, --'''0' w..~cted pursuanHo:the law.
2. This!infonnntion'will' be' used ,to create and, maintaura',recordof"oiLal1d:
g¡¡¡¡/geot);lemmLlease, activity. .
3 .,R~J?~~:~tQ-¡Ns're.qu.est.i5 required to.:(Jbtain ,benefit·, "".::'rt.~;~,
B1;M'w,oWd:like-you'(t91'know thalqoudo not'have' to respond tô.'tlÜš,',btiariYf.ôÏlÍer
Fede~al:;ag.encý spqnsored~jnfonnation,' collection: unless' it,displays:~a~currentlÿ;
vali~Q~,~,C,?-~~b:lUm1?e~.,
NOTICE'" ''''
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The~_Bri.V.~~y"Ac.,~i9,f;'1?74;an,5h}\1e.·regula.ti,9n, ~4~·CI¡R:2.48(ç!),iRrqy,i!ic;¡)thayy,9~þe:,
fur;g,iS¡¡~i~,;,j:t:¿¡Wi'~~~~in!:~on,in.co.nn~on¡w;ith-,inf~~tion-;~lI¥i~,:~y:\'thís
oil,.and:,g1Is~,~?,~~~J9ISe_.I;c:cord"title.,ass¡gnment:,appli~aUQn"r ,,". ",i;l:",·:~,
.:.,.;..... -"/':,..L,'
Au.œ.O~~\3Ji¡,jæ:s:E ,1Ú:et,.seq; 30U .S.C..lOÓ'l,,~02,5,;:42, U;~S;-(Ú6ßP8;
·-:::.'.'.~.:·;:~,~~-·.;~::.~~::.~fô~"~~~'" _.~;~.' .\.--" :.' ~-. .,u - .,. .;;;~: . "~'<:l{;~",_,~_
P~ÇIP:AL,B~QªE,,;-T.!¡.~.infor;n;µ¡tiQn:is,to;be,us~:~OI!Pf~~~s,,=rd::tit!~,as-
sigµmen~~for...o.il~d,~~~gëo.t1iex;o:!ãl,;x:esources.leas!:S.,' _ _ " .
'RO~,.USES"
(00039
(1);1;I;1e,¡@.uØiça.tion of the assignee'srights to the land or resources.
. -~'ï, .,:....;...~."''..,;. "",~,,,!o:,<, .
~t$P:~I~~~~>~ifoI:PlJbJiC info~o~ in sup'port of nota~onsmaœ onJandstams
,~oiè!S;:fox::-:~t!ic:;;manag~ment, disposal, and use of public lands and resources.
',~~.- ,-. '. -.': '..::; :,::r~'··" .
),)ïi¡i~}f~eral ag,encics when concurrence is requ~ prior to
\~~_p~b¥~ds"or resources.
;(4!){5~dn{0Ji11;13.tÌOIl,~mithe;,recordandlol"the-rccord will be transferred to appropri-
j,at!::'E~'StateiHQcalior,foreign'agencies,.when.relevant to'civil, criminal, or'reguIa-
'"to:~~~~~¡;~!q~p~secUtions.
, "". J', - :INGdNFORMA'JJI0N-If:alhequestec¡'¡Dfonna-
;,·",'~i¡¡iliir,'IlSSÌgnment:anay~nol'.be.approv.ed~ 'See"regUlations at
.s~3'1,OO:¡and~\3200,
-'.::;';"·,;~:f~:8\, Tear
_ _Tear ___ _ _ --:"'_',~'''''''-:-'_~--:'':''''_ _ _ __.._._~._.._:_~.~.._._ __.--:-_____ _ _ __ _ _ ___
.....
Part A (Continued): "ADDIDONAL SPACE for Names and addres¡¡es ofadditionaLassigx¡.eesJnJtem No.1, if needed, or foc Land Description in Item No.2, if
needed.
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PART B: CERTlFICATJo.N AND'REPUEST FOR APPROV.AL
1. The Ass.ignor certifies.as owner ·,f a~ in tcrest in..the above .d:~ígnated.Jease Ihath~/she hcreby assigns to the above as~i,gnee{s) the rights specified above.
2,. A¡ssignc.e certifies as follows: (a),Assignee' is a cilÍzell of the,United,States;, an assocJation oC such ,citizens; a mun ¡cipaUty; or a corporation organized under th~
làws'oCtbe' Un ited s'la,tes,orof anySta Ie ,or terrilorythereof.,For the,;a,ssignmen t ofNPR-A leases",assignee is a citizen, national, or 'r.esident alieu, oftheUllited
Sitates"orassocí~,tíon"o.f;such:citizeus, nationals"resident ali.ens;,o,r privatc"public or"municipal cor;poralions, (b) Assignee is notco,nsidered a minor.uuder tbe
laws:o[~he.Statdn,:wh:i,ch,the.]ands,cover,ed by,lhis,ass.!g~,m,~nt.\:¡,re located; -(c) Assignee's chargeJlble interests, ,direct and indirect"i~ eaebpublic domain and
a~qu1ted,.land$·separately.in·tlie'sam'èStatè;-do'j¡o¡;,cxcëed'.2~6';Ø~80'acres in:o,iland,gas leases(~fwhic.h up.-to 200~OOO ac,res may bein oilaud gas 'options), or
3þO,OOQ;'acre.s':.in "IeasesJn each leas,ing'District,iifAl¡¡$¡¿£:·.ofr;w.liTi:~::uJi'(0201J;OOO'acres \l\ay- be in.:,options. ¡fthis is an oil and gas lease'issued'inaccordauce
wÏtli th~;~MïlÍ.eran.easiÌlg Act Qf.1920.-.0r'5il;20'O,'a,cresJn any"'O,ne SÙÚe iLihis is, a g,~othermal.1e.a'se;' (d) 'All, pUlies holding an in terest in"the assignmeu·¡ are
olhe¡w,Î.se':,jn, cOIl1:p.üance'w,itb"the:regula:t'ion5'(.4,3·,eF-R;-'Gro'lrp'31 OO'or 3200) a nd'lhe aulho riÚng Acts; '(e) Assignee ¡sIn co m plíao'ce with reclamation-
'r~~,u¡~i1f~ß.,~:For)JI::I.':¿de(aboil'and:gas;leasdo'¡d,j¡ig5,asre,q,uired by 5ec.' 17(g) oC.the,Mineral' Leasing Ac!;,and (I) Assignee 1s not in violation oC sec. 41 of the
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;_".,M1nera ' l.~~i~~;;;;::~Äi;':.;;;.:";£;ú;.~;:;'" -':tá,i¥i¿:"::;~r~:'I<:.i..'ê;¡"i~Ix'-".:,~",,~;.".,-.~,:~ ,,' ",;;::"""", _ , .
'3'; , 11l,r~,'tp..rhls\asihgnmenl';<:onst, ic2è:pl~'Ì(c.i:~~~t'~.a'IC~pþ'I,i,c';¡Ble;.Ie,ni1~;'~oD1diÏì~ns,~'tipùià¡ions and rc;trictions. pertaining to the lease described
..... ."".
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For geo,therma!cassi!¡\,nme.nts, anov,e.\Tidj¡¡g.royalty'ma~ not belessthan'one-fo'urth'(1/4) oConé percentoC the value of output; nor grca,ter than 50percentoC the rate of
royaltY' þu e:¡o, the,JJn'ite.d :Stales.'whcn,lhís assjgnment.is added" to all-prevIously. 'c.reated·ov~rriding roya.llics.".(43CFR 3241). ,
." '. - - .
I certify."that 'the' staicments made herem by' me are trUe, complete" and correct to ~e best of my knowledge and belief and ,are made in good tiiith.
Exe;út;~';thi~}'..J.:'vl' day o~ 1 ú. fL P ,~Execated this ,"3 - day of 'S"'^'-.
, . Frank A. Mau
NameQf.Ass~gnor,as shown on ,currenUease
- ."l;:&,' "''''''~'~ A..'~ ~peor·P?n~ '
ÅsslgnO ...--- '- " .
or "Frank A. Ma u (Signature)
Attomey-incfact
2ß165
(Signature)
preakness Drive
(Assignor's Address) ,~""'"
Oaks RaI1ch,.TX; 78015
(City)(~,tatC)
,~P.';£,~~)
Fai:¡;
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,~200<¿
0.-.. . ~~
' Bryan . au
or
~~
(Signature)
AttomeÝ.~iD"fact
.
()M/~
(Signature)
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C:i:~/) ~:: T;·¡(,;;');,·.~' ~_ í1
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Public ~porting bu:de':1 for this fonn i~estimatt\d to average .30 minut~ per ~ponse including the time for r~viewing 'instrUctions, galheringand maintaining data, and
completmg and reVlewmg.,th,e fonn. D!I'ect comments regarqmg the ,burden estimate or ,any other, aspe.cLof this fonn to, U.S. Department of the' Interior Bureau of Land
Mana~ment(1004.;-003.4),Bureau Clearance Officer ,(WO-63Q).1:MiúfStop..40LLS, 'l849iC.Strèet;;N::W:,WaSlÜngton, D.C. 20240. ' ,
Title:18 '11J:S,CSec.-,lOO~ makes it a,crime'fOì any person knowingly- and willfully to,make·to;any~Department or agency of the UlÙted States any false fictitious or ftaudul t
statements or representations as to any matter within its jurisdiction. '" ,en
NOTARYACKNO~EDGMENT
L~00040
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
, N1ittÞ,..,..........ø:..~____,...tII,,__,..,_~___..........,..........""""' LW
I THEDAA. PORTER - NOTARY PUBUC
COUNTY OF 'STATE OF Th da A. Porter Notary Public
SWEETWATER WYOMING '
MY COMMISSION EXPIRES AUGUST 1. 2009
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