HomeMy WebLinkAbout876713 mum 3000-3 UNITED STATES FORM APF'ROVED
(;~.~ ~,6) !' . . u: : i':. DEPARTMENT OF THE INTERIOR
· "':'..' .; c'. r .~. h BU~AU OF LAND MANAGEMENT
~..' :~ ~...3 ~, " Expires: September30 1998
-.~81GNMENT OF RECORD TI/L~ INTEREST IN ~ Lease Serial No.
~ ~ 3~[-' "5 [X[~~R OIL AND'GAS OR GEOTHERMAL RESOURCES
e"x ["~' ~'~ [:;7 V~/~.'", ~J~ineral Leasing Act of 1920 (30 U.S.C. 181 et seq.) Lease Effective Date
,~,,C[t~17 x t (~i}~orAcqmredLandsof1947 (30U.S.C. 351-359) 6/1/94
~1 Lrxt~L' ~'~ 'Geothemal Steam Act of 1970 (30 U.S.C. 1001-1025) New Lease Serial No.
Depa~ment of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508)
T~e or pri3~ln ink and sign In Ink.
PART A: ASSIGNMENT ~¢O~K ........ ~_~_PE PA~_~
L Assignee* BgLCO ~RCY ] L. P.
Street 5735 PINELAND, SUITE 300 f'~ '? (~: ~ IV ~ ~)
City, State, ZIPCode DALLAS, TX75231 ~..~(~(~}~ ~'~ (~?~ ~¢'~ .... , ~,~,
*Ifmore than one assignee, cheekhere ~ and list the name(s) and ~r~s~)~a]l ~itional assignees on the rev - s ~r"r~r~or¢4a
separate a~ached sheet of paper. ~J ~ { ~ ..... ,,~ O' ,j ,
This record title assignment is for: (Check erie) Oil and Gas Lease, or . Geothe~al L~as; d ~:;~/~ ?"] ~".J :~Z.'~' .~, {~ [ ..,~ ~ ~; ~ , ,
I~t~rest conveyed: (Ch~ck one or both, as appropriate) Record Title, OreRJdi~g ~oyalty, payment out of production or other similar
J~terests or payments
2. Ihis assiga~ent conwys the followi~g inter~st:
La~d Description ~erce~t of Inter~st Percem of
Additional space on reverse, if needed. Do not submit documents or aBreements other Owned Conveyed Retained Overridin~ Royalty
than this fo~; such documents or agreements shall only be'~eferen~ed hereim
or 8i~ilar Interests
Rescued Previously
reserved
or conveyed
a b c d e f
TWP 23N, RGE l13W, 6TH P.M. 33.33% 16.6650% 16.6650% NONE
SEC 3: ALL
OF 33.33%
640.00 ACRES, M/L FOR ~SSIGNE E
LINCOLN COUNTY, WY
, FOR BLM USE ONLY ---DO NOT WRITE BELOW THIS LINE --
. UNITED STATES OF AMERICA
This assignment Is approved solely for admlnistrath, e PUrposes. Approval does not warrant that either party to this assignment holds legal or
equitable title to this lease.
~Assignment approved for above described lands; ~ Assignment approved for'attached land description
Assignment approved effective AUG0 1 2001 ~ Assignment approved forland dcscription indicated on reverse
of this form.
By t'$[ 4, LeWiS Chle Fluid Minerals
(Authorized officer) -- (Title~--- ~' (Date)
.,;~!~., , :;' ..- - :., ,
STATE OF TEXAS
COUNTY OF DALLAS
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME BY GARY BYRD, VICE PRESIDENT -- LAND OF BELCO ENERGY CORE. A NEVADA CORPORATION.
ACTING AS GENERAL PARTNER OF BELCO ENERGY 1 LP., A DELAWARE LIMITED PAWF~RSHIE, ON BEHALF OF SAID PARTNERSHIP
THE STATE OF TEXAS
CO~TYOFHA~IS flq~ 'z'~t~ e~-~ .~
THE FOREGO~G INSTRUMENT WAS AC~OWLEDGED BEFO~ ME BY TOM L. DODDS AS VICE PRESIDENT OF ANDEX RESOURCES, L.L.C
A TEXAS LIMITED LIABILITY COMPAq, ON BEHALF OF SAID COMPAq. · . '
. E THIS THE 'ST DAY~ ~" ~F.OCTOBER, 2000.. /~g..
~R~fi~IC ~ ~N~ F~i THE STA~ TEXAS
'~ ..... RTIFIGAIION AND REOH~$T FOR APPROVAL
1. The assi~or ceaifies 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 ce~ifies as follows: (a) Assignee is a citizen of the United States; an association of such citizens; a municipality; or a co~oration organized under the laws
of the United States or of any State or teffito~ thereof. For the assignment of NPR-A leases, assi~ee is a citizen, national, or resident alien of the United States or
associations of such citizens, nationals, resident aliens or private, public or municipal co¢orations; (b) Assignee is not considered a minor under tho law of the State
in which the lands covered by this assignment are located; (e) 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 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 Alas~ of which up to 200,000 acres may be in options, if this is an oil and gas lease issued in accordance with ~e Mineral Leasing Act of 1920, or 51,200
acres in any one State if this is a geothemal lease; and (d) All paaies holding an interest in the asssignment are othe~ise in compliance with the regulatimm (43 CFR
Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in compliance with reclamation requiremenU for all Federal oil and gas lease holdings as required by see. 17(g)
of the Mineral Leasing Act; and (f) Assignee is not in violation of see. 41 of the Mineral Leasing Act.
3. Asaignee's signature to this assignment constitutes acceptance of all applicable terns, conditions, stipulations and restrictions pe~aining to the lease described herein.
For geothermal transfers, an ove~iding royalty may not be less than on-efounh (~) 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 ove~iding royalties (43 CFR 3241).
I cefli~ that the statements made herein by me are tree, complete, and co~ect to the best of my knowledge and belief and are made in good faith.
Executed this IST day of OCTOBER 200 0 Executed this ~ day of
Name of Assignor as shown on cu~ent lease ANDEX RESOURCES, L.L,C. Belco Energy I L.P.
Please type or print By: B~, Corp. its General Partner
Asslgne~ ~.
Assignor
A~omey-in-fact Attorney-in-fact _
1001 FA~, SUITE 2000
(Assignor's Address)
HOUSTON, T~ 77002
(City) (State) (Zip Code):
BURDEN HOURS STATEMENT
Public reposing burden for this fern is estimated to avenge 30 minutes per response, 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 fern to U.S. Depa~ment of the Interior, Bureau of Land
Management, Bureau Clearance Officer, (DW-I10), Denve Federal Cener, Building 40, P.O. Box 25~7, Denver, CO 80225-0047 and the Office of Management and
Budget, Paperwork Reduction Project (1004-0034). Wa~hingto n, D.C. 20503.
Title 18 U.S.C. Sec. 1001 makes it a crime for any person knowingly and willhlly to make to any Department or agency of the United states any hlse, fictitious or ~audulent
statements or represenlations as to any matter within its jurisdiction.
· U.S. G~O: ~992-174-0~7187023