HomeMy WebLinkAbout952127Land Description
Percent of Interest
Percent of
Overridingg Royalty
Similar Interests
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.
a
Owned
b
Conveyed
Y
c
Retained
d
Reserved
e
Previously
reserved
or conveyed
f
T24N, R116W Secs 04,20 1346.88 acs described as follows:
Section 04 Lots 1 -12 and S/2
Section 20 E /2, E/2 W/2
Lincoln County, Wyoming
RECEIVED 2/11/2010 at 10:46 AM
RECEIVING 952127
BOOK: 742 PAGE: 373
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
100.00%
100.00%
DO{•BLM
CHEYENNE WYOMIHri
0
2010 JAN 14 AM 9: GO
0
0
RECEIVED
0.00%
GnR at ne t IqF nNi V DO NOT WRITE BELOW THIS LINE
Form 3000 -3
(May 2006)
Interest conveyed: (Check one or both, as appropriate)
Assignment approved effective
By
(Continued on page 2)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
ASSIGNMENT OF RECORD TITLE INTEREST IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.)
Act for Acquired Lands of 1947 (30 U.S.0 351 359)
Geothermal Steam Act of 1970 (30 U.S.C. 1001 -1025)
Department of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C.
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
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 El and list the name(s) and address(es) of all addtional assignees a separate attached
sheet of paper.
This record title assignment is for: (Check one) Oil and Gas Lease, or Geothermal Lease
This assignment is approved solely for administrative purposes.
title t this lease.
Assignment approved for above described lands;
FEB 0 1 2010
FORM APPROVED
OMB NO. 1004 -0034
Expires: April 30, 2009
Lease Serial No.
'YW 174823
ase Effective Date
nniversary Date)
i/01/2007
New Serial No.
R e c o r d Title, Overriding Rc, t payment out of production or other similar interests
or payments
UNITED STATES OF AMERICA
Approval does not warrant that either party to this assignment holds legal or equitable
Assignment approved for attached land description
Assignment approved for land description indicated on reverse
of this form
LAND LAW EXAM IN ER WAN 2 2 2010
IS! Judith R. Okk^nhura
Bureau of Land Management (BLM) (Title) (Date)
Part A (Continues): rIONAL SPACE for names and addresses of additic lees in Item No.1, if needed, or for Land Descripl i 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. L
S r DECEMBER 20 09
day of DECEMBER 2 0 09 E xecuted this .3 day of
Executed this
Name of Assignor as shown on curren
Assignor
or
Attorney- ,f' ct
2201 CABIN COURT
GILLETTE
(City)
(Continued on page 3)
lease MEATH, LL
(Signature
(Assignor's Address)
WY
82718 -5244
(State) (Zip Code)
Title 18 U.S.C. Sec.1001 makes it a crime for any person knowingly and willfully to make
fraudulent statements or representations as to any matter within its jurisdiction.
(Please type or p
Assignee
(Sig
or
Attomey -in -fact
David E. Lancaster,
Executive Vice President and CFO
MRC ROCKIES COMPANY
5400 LBJ Freeway
One Lincoln Centre, Suite 1500
Dallas, TX 75240 -1017
to any Department or agency of the United States any false, fictitious, or
(Form 3000 -3, page 2)
STATE OF WYOMING
COUNTY OF CAMPBELL
The foregoing instrument was acknowledged
Wyoming, by
December, 2009.
TERI M STOREY NOTARY P LIC
COUNTY OF STATE OF
CAMPBELL +ii.: r! WYOMING
MY COMMISSION EXPIRES
My Commission Expires: 03 -13 -2012
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 31 day of December, 2009.
Notary Public,
State of Texas
Comm. ExpO8 -20-11
My Commission Expires: 08 -20 -2011
ACKNOWLEDGMENTS
re me, a Notary u in a for the State of
as
of Meath LLC, on this f day of
I
Teri M. Storey
v• ne Hoevers
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