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HomeMy WebLinkAbout942046 fORM )000·) (January 1996) JNITED STATES DEP ARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT ASSIGNMENT OF RECORD TITLE INTEREST IN A LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES FORM i\rn<..vvED OMB NO. 1004-0034 Expires: September 30, 1998 Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.) Act for Acquired Lands of 1947 (30 U.S.c. 351-359) Geothennal Steam Act of 1970 (30 U.S.c. 1001-1025) Department of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508) Lease Serial No. WYW 310649 Lease Effective Date (Anniversary Date) 8/01/64 New Lease Serial No. Type or print plainly in ink and sign in ink. PART A: ASSIGNMENT 1. Assignee* Street City, State, ZIP Code IRW HOLDING COMPANY, LLC 700 LOUISIANA, SUITE 1100 HOUSTON, TX 77002 OOü334 *If more than one assignee, check here separate attached sheet of paper. This record title assignment is for: (Check one) 0 o and list the name(s) and addressees) of all additional assignees on the reverse of this fonn or on a Interest conveyed: (Check one or both, as appropriate) Oil and Gas Lease, or o Record Title, o Geothennal Lease o Overriding Royalty, payment out of production or other similar interests or payments 2. This assignment conveys the following interest: Land Description Percent ofInterest Percent of Additional space on reverse, if needed. Do not submit documents or agreements other Owned Conveyed Retained Overriding Royalty than this fonn; such documents or agreements shall only be referenced herein. or Similar Interests Reserved Previously reserved or conveyed a b c d e f TWP 22N, RGE 112W, 6TH PM 0.66667% 0.66667% NONE SEC 7: LOTS 7, 8, SW/4NE/4, E/2W/2, W/2SE/4, NE/4SE/4 OF 8/8THS OF 8/8THS SEC 18: LOT 5, NW/4NE/4, NE/4NW/4 '-'" RECEIVED 9/8/2008 at 11 :57 AM ::;"-" CJ 0 ;;JI RECEIVING # 942046 :;¡: :J' co ~\ I ¡"f' ,..' , ;:-.. :~~. c; BOOK: 704 PAGE: 334 -< fl" c::: rr¡· Ç) -.~,' . ~ 11; Î JEANNE WAGNER Z(" _.- r- ::; '" fti fI' ....- ,1>. LINCOLN COUNTY CLERK, KEMMERER, WY . . I A_ :1£ -. Çw~ ~ 554.17 ACRES, MIL -«, '::Z .- ~r o ¡-Ii ~~. - LINCOLN COUNTY, WY 1,.0 ...... ~C) G¡.. ~::::~ r"" C) c:.) I~~ z... ..:..1114- ~'!) "" -,;> "" 'V -~ ~ z ..... ~, ::t; ~ .;: ..., rl ::c <3 :to FOR BLM USE ONLY -- DO NOT WRITE BELOW THIS LINE UNITED STATES OF AMERICA , .., '!:;:', .:1' This assignment is approved solely for administrative purposes. Approval does not warrant that either party to this assign;rlmt holÎls lègal or equitable title to this lease. D Assignment approved for above descri'bed lands; Assignment approved effective D Assignment approved for attached ¡and description D Assignment approved for land description indicated on reverse of this fonn. By (Authorized Officer) (Title) (Date) Part A (Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No. I, if needed, or for Land Description in Itcm No., 2 if needed éOû335 THE STATE OF TEXAS COUNTY OF HARRIS BEFORE ME, THE UNDERSIGNED AUTHORITY ON THIS DAY PERSONALLY APPEARED GARY WINSTON, ATTORNEY-IN-FACT FOR DANIEL WOLF, KNOWN TO ME TO BE THE PERSON WHOSE NAME IS SUBSCRIBED TO THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED TO ME THAT HE EXECUTED THE SAME FOR THE PURPOSES AND CONSIDERATION THEREIN EXPRESSED. GIVEN UNDER MY HAND AND SEAL OF FFICE HI THE 1ST DAY OF JUNE, 2008. MY UBLIC IN AND FOF THE STAT~XAS LOUISE R WONZER My Commission Expires June 15, 2008 CATION AND REQUEST FOR APPROVAL I. 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 citizcns; a municipality; or a corporation organizcd under thc laws of the United States or of any State or territory thereof. For the assignment of NPR-A Icascs, assignec is a citizen, national, or residcnt alicn of thc Unitcd States or associations of such citizens, nationals, resident aliens or private, public or municipal corporations; (b) Assignee is not considered a minor under the law of the State in which the lands covered by this assignment are located; (c) Assignee's chargeable interests, direct and indirect, in each public domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leascs (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; and (d) All parties holding an interest in the asssignment 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 Mineral Leasing Act. 3. Assignee's signature to this assignment constitutes acceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease dcscribcd herein. For geothermal transfers, an overriding royalty may not be less than on-efourth ('I.) of onc 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 royaltics (43 CFR 3241). r 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 1 ST day of JUNE 2008 Executed this day of ,19_ Name of Assignor as shown on current lease DANIEL WOLF Please type or print Assignor Assignee or (Signature) Attorney-in-fact ·t;; .i :}. .., (Signature) 700 LOUISIANA, SUITE 1100 (Assignor's Address) HOUSTON, TX 77002 (City) (State) (Zip Code) BURDEN HOURS STATEMENT Public reporting burden for this form is ~stimated to average 30 minutes per rcsponse, including the time of reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land Management, Bureau Clearance Officer, (DW-IIO), Denve Fedcral Cener, Building 40, P.O. Box 25047, Denver, CO 80225-0047 Bnd the Office of Management and Budget, Paperwork Reduction Project (1004-0034). Washington, D.C. 20503. Title 18 U.S.C. Sec. 1001 makes it a crime for Bny person knowingly and willfully to make to any Department or agency of the United states any false, fictitious or fraudulent statements or representations as to any matter within its iurisdiction. ·U.S. GPO: 1992-774-017167023