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Home My WebLink About941568 t\ - - "'11.2 ....' UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT FORM APPROVED OMB NO. 1004-0034 Expires: September 30, 1998 Form 3000-3 (January 1996) ........ '" ASSIGNMENT OF RECORD TITLE INTEREST IN A LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES Lease Serial No. WYW-174572 Lease Effective Date (Anniversary Date) February 1, 2008 New Serial No. 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) Type or print plainly in ink and sign in ink. PART A: ASSIGNMENT 1, Assignee· Street City, State, ZIP Code EOG Resources, Inc. 600 Seventeenth Street, Suite 1000N Denver, CO 80202 ·If more than one assignee, check here 0 and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate attached sheet of paper. This record title assignment is for: (Check One) 181 Oil and Gas Lease, or o Geothermal Lease Interest conveyed: (Check one or both, as appropriate) 181 Record Title, o Overriding Royalty, payment out of production or other similar interests or payments 2. This assicnment conveys the followina interest: Land Descriction Additional space on reverse, if needed. Do not submit documents or agreements other than this form; such documents or agreements shall only be referenced herein. Percent of Interest Owned Conveyed Retained Percent of Overriding Royalty or Similar Interests Reserved Previously reserved or conveyed e f None None a Townshio 21 North, Rance 113 West. 61r P,M. Section 24: Lots 1(35.07),2(35.54),3(36.00),4(36,47), W2E2 Containing 303.080 acres, more or less Lincoln County, Wyoming bed 100.00% 100,00% None "1-1 ~ I' / ,^ 'I /, . RECEIVED 8/25/2008 at 4:01 PM RECEIVING # 941568 BOOK: 703 PAGE: 112 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY I I I I 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, ' o Assignment approved for above described lands; Assignment approved effective o Assignment approved for attached land description o Assignment approved for land description indicated on reverse of this form. .~ '¡ "'.I~ ~ ',j. "'~ By (Authorized Officer) (Title) ¿~ 7/ £/;¿ é) -' ()<;) d (Date) ),/'/)"7,.. ,'" /':,/'~,~o(.~" 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. ) (;Oû1.:13 The foregoing instrument was acknowledged before me the 2nd day of February, 2008, by C. Steven Stacy, as President of Hoover & Stacy, Inc. WITNESS my hand and OffiCi~ My Commission Expires: ~ It'! 1'1, -'-011 Curtis A. Bold, Notary Public PART B: CERTIFICATION AND REQUEST FOR APPROVAL 1. The Assignor certifies as owner of an interest in the above designated lease that he/she hereby assigns to the above assignee(s) the rights specified above. 2. Assignee certifies as follows:(a) Assignee is a citizen of the United States; an association of such citizens; a municipality; or a corporation organized under the laws of the United States or of any State or territory thereof. For the assignment of NPR-A leases, assignee is a citizen, national, or resident alien of the United States or association of such citizens, nationals, resident aliens or private, public or municipal corporations, (b) Assignee is not considered a minor under the laws of the State in which the lands covered by this assignment are located; (c) Assignee's chargeable interest, direct or indirect, in each public domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases ( of which up to 200,000 acres may be in oil and gas options), or 300,000 acres in leases in each leasing District In Alaska of which up to 200,000 acres may be In options, if this is an oil and gas lease issued in accordance with the Mineral Leasing Act of 1920, or 51,200 acres in anyone State if this is a geothermal lease; (d) All parties holding an interest in the assignment are otherwise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in compliance with reclamation requirements for all Federal oil and gas lease holdings as required by sec. 17 (g) of the Mineral Leasing Act; and (f) Assignee is not in violation of sec. 41 of the Minerai Leasing Act. 3, Assignee's signature to this assignment constitutes acceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease described herein. For geothermal assignments, an overriding royalty may not be less than one-fourth (1/4) of one percent of the value of output, nor greater than 50 percent of the rate of royalty due to the United States when this assignment is added to all previously created overriding royalties (43 CFR 3241). I certify 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 faith. Executed this 2nd day of February ,20 08 Executed this 1""'- day of ¿fÁL~ ,20 ¿) j;> Assignor or Attorney-in-fact Hoover & Stacy, Inc, Please type or print EOG Resources, Inc. . Steven Stacy, President No Attest Required Assignee or Attorne ~-...., PO Box 2328 James C, Fletcher Agent & Attorney-m-FaCT Cheyenne 82003 (Assignor's Address) , wy (City) (State) (Zip Code) \ '" 2007 - ~ \, ..: \ h~"" .... .:- "'" :'J'4'" \ ~ .. " " 't " '#'"".~MI"'~."," .,~ :·i