No preview available
HomeMy WebLinkAbout952048UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT AWIGNMENT OF RECORD TITLE INTEREST IN A DEC 23 R KSE FOR OIL AND GAS OR GEOTHERMAL RESOURCES RECE E-0 Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.) _BLM Act for Acquired Lands of 1947 (30 U.S.0 351 -359) si �othermal Steam Act of 1970 (30 U.S.C. 1001 1025) vi ar tm�ent of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508) Form 3000 -3 (May 2006) Interest conveyed: (Check one or both, as appropriate) a 24N120W02,03,04 1,552.84 acs described as follows: Section 02 Lots 6, 9- 13,15, 22, 24 -26, 29, SW /4 and S/2 SE /4 Section 03 Lots 5 -8, 10 -16 and S/2 Section 04 Lots 6 -8 Lincoln County, Wyoming Assignment approved for above described lands; Assignment approved effective JO 0 1 26111 By (Continued on page 2) fat Bureau of Land Management (BLM) Type or print plainly in ink and sign in ink. 1. Assignee* MRC ROCKIES COMPANY Street 540Q LBJ FREEWAY, ONE LINCOLN CENTRE, SUITE 1500 City, State, Zip Code DALLAS, TX 75240 -1017 la. Assignor *If more than one assignee, check here and list the name(s) and address(es) of all addtional assignees on page 2 of this form or on a separate attached sheet of paper. This record title assignment is for: (Check one) Oil and Gas Lease, or n Geothermal Lease PART A: ASSIGNMENT 2. This assignment conveys the following interest: Land Description Additional space on page 2, if needed. Do not submit documents or agreements other than this form; such documents or agreements shall only be referenced herein. Record Title, Overriding Royalty, payment out of production or other similar interests or payments Percent of Interest Owned b Conveyed c Retained d Reserved e 100.00% 100.00% tilt,) 1 !AAA' e& a p. A (Title) 0.00% GIFT a FORM APPROVED OMB NO. 1004 -0034 Expires: April 30, 2009 Lease Serial No. WYW 174335 Lease Effective Date (Anniversary Date) 01/01/2008 New Serial No. 006064 Percent of Overridin Royalty Similar Interests 0.00% El Assignment approved for attached land description El Assignment approved for land description indicated on reverse of this form ii kl Previously reserved or conveyed f 0.00% REC EIVED 2/8/201 at 1 05 PM RECE 952048 BOOK: 742 PAGE: 64 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 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. JAN 1.5 201( (Date) ti Part A (Continued): ADDITIONAL SPACE foi ■_,es and addresses of additional assignees in Item No.1, if. .ed, or for Land Description in Item No. 2, if needed. PART B CERTIFICATION AND REQUEST FOR APPROVAL 1. The Assignor certifies as owner if 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 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 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 any one 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 Mineral 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 T da of c-- Executed this 4- Name of Assignor as shown on current lea Assignor Da E. Lancaster, Exe ive ice -Pres. CFO (Signature) 5400 LBJ FREEWAY, ONE LINCOLN CENTRE, SUITE 1500 DALLAS (City) (Continued on page 3) day of S) EC- 20 09 MATADOR RESOURCES COMPANY (Assignor's Address) TX 75240 1017 (State) (Zip Code) (Please type or Ar' °nee 000065 20 09 David E. Lancaster, Executive Vice -Pres. CFO MRC ROCKIES COMPANY 5400 LBJ Freeway, One Lincoln Centre Ste 1500 Dallas, TX 75240 -1017 Title 18 U.S.C. Sec.1001 makes it a crime for any person knowingly and willfully to make to any Department or agency of the United States any false, fictitibus, or fraudulent statements or representations as to any matter within its jurisdiction. (Form 3000 -3, page 2) STATE OF TEXAS COUNTY OF DALLAS The foregoing instrument was acknowledged before me, a Notary Public in and for the State of Texas, by David E. Lancaster, Executive Vice President and CFO of MRC Rockies Company, on behalf of said company, on this 14 day of December, 2.009. My Commission Expires: 08 -20 -2011 ACKNOWLEDGMENT CO ii066 l e Ai. AZ _Cr A ne Hoevers