HomeMy WebLinkAbout952051UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
ASAIPNMENT OF RECORD TITLE INTEREST IN A
It EIFOR OIL AND GAS OR GEOTHERMAL RESOURCES
tit neral sin A of 1920 U.S.C. 181 t e q.)
c
Act Mi for Acq g ct Lands of 1947 30 (30 U 35 e -s 3 59)
4 gothermal Steam Act of 1970 (30 U.S.C. 1001 -1025)
plit}t btrTht Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508)
Type or print plainly in ink and sign in ink.
Form 3000 -3
(May 2006)
1. Assignee* MRC ROCKIES COMPANY
Street 5400 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)
Interest conveyed: (Check one or both, as appropriate)
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.
24N120W27,28,33, 2052.52 acs described as follows:
Section 27 All
Section 28 Lots 5 -8
Section 33 Lots 5 -8
Section 34 All
Section 35 N/2 NE /4, NE /4 NW /4, S/2
Assignment approved effective
By
(Continued on page 2)
a
Lincoln County, Wyoming
Bureau of Land Management (BLM)
PART A: ASSIGNMENT
Oil and Gas Lease, or Geothermal Lease
rA
FORM APPROVED
OMB NO. 1004 -0034
Expires: April 30, 2009
Lease Serial No.
WYW 174338
Lease Effective Date
(Anniversary Date)
01/01/2008
New Serial No.
C:0 07 3
Record Title, Overriding Royalty, payment out of production or other similar interests
or payments
Owned
b
100.00%
Percent of Interest
Conveyed
c
Retained
d
100 0.00%
Reserved
e
0.00%
RECEIVED 2/8/2010 at 1 :07 PM
RECEIVING 952051
BOOK: 742 PAGE: 73
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMER
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
Assignment approved for above described lands; El
titlat�o this lease. Assignment approved for attached land description
8
JAI 4 1
(Title)
Percent of
Overriding Royalty
Similar Interests
Previously
reserved
or conveyed
f
0.00%
ER, WY
Assignment approved for land description indicated on reverse
of this form
JAN 1 ;S 2010
(Date)
Part A (Continucuj. twiNTIONAL SPACE for ;s and addresses of addi.....__. ___,gnees in Item No.1, if d, or for Land Descr em 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 1 1
Assignor
day of .1) C._C- 20 09
Name of Assignor as shown on current le e MATADOR RESOURCES COMPANY
S l
David E. Lancaster, utive Vice -Pres. CFO
(Signature)
5400 LBJ FREEWAY, ONE LINCOLN CENTRE, SUITE 1500
DALLAS
(City)
(Continued on page 3)
(Assignor's Address)
TX 75240 1017
(State) (Zip Code)
Executed this I
(Please type
or p
ssig
o r
000074
day of bEC__
(Si. atu e)
20 09
(Signature)
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, fictitious, or
fraudulent statements or representations as to any matter within its jurisdiction.
(Form 3000 -3, page 2)
STATE OF TEXAS
COUNTY OF DALLAS
ACKNOWLEDGMENT 00 0 75
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, 2009.
•�'1" YVONNE HOEVERS
Notary Public,
I Pi�!�r State of Texas
2C Comm. ET. 080.11.
My Commission Expires: 08 -20 -2011