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HomeMy WebLinkAbout952133v a Land Description Percent of Interest Percent of Overriding Royalty Similar Interests space on page 2, if needed. Do not submit documents or agreements Additional s P P g g 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 T25N, R118W SECS 18,19,30 504.83 acs described as follows: Section 18 Lots 6, 7, 10, 14, 16, 17, 20, 26 -31 Section 19 Lots 9 -12, 26 -28, 31 Section 30 Lots 21 -24 Lincoln County, Wyoming RECEIVED 2/11/2010 at 10:58 AM RECEIVING 952133 BOOK: 742 PAGE: 391 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 100.00% 100.00% 3NN31k3H3 HiELteq. 2010 JAN 14 Ate 9: 00 a r.FIVFn 0.00% GnP RI M 11QF rims v nn NOT WRITE BELOW THIS LINE F.orm 3000 -3 (May 2006) Assignment approved effective UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT ASSIGNMENT OF RECORD TITLE INTEREST IN A LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCE 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. E Interest conveyed: (Check one or both, as appropriate) t: FEB 01 2010 B /Si Judith R. Oldenburg Bureau of Land Management (BLM) (Continued on page 2) Type or print plainly in ink and sign in ink. PART A: ASSIGNMENT 0 ase Effective Date (Atiniversary Date) 04/01/2008 FORM APPROVED OMB NO. 1004 -0034 Expires: April 30, 2009 Lease Serial No. YW 174830 w Serial No. 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 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 Geotheimal Lease OO.: ?91 Record Title, Oveniding Royalty, payment out of production or other similar interests or payments 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 t this lease. 9( Assignment approved for above described lands; Assignment approved for attached land description Assignment approved for land description indicated on reverse of this form LAND LAW EXAM' SAN 2 2 2010' (Title) (Date) Part A (Contin1ea/: Huur i'IONAL SPACE for names and addresses of additiot__. _._._.es in Item No.1, if needed, or for Land Descripti 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). 1 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. DECEMBER 09 3 l day of DECEMBER 20 09 day of 20 Executed this Y Executed this Assignor or Attorney GILLETTE MEATH, LLC n re l i� ure Signature) print) (Signatu Name of A ssignor as show 2201 CABIN COURT (City) (Continued on page 3) current le (Assignor's Address) WY 82718 5244 (State) (Zip Code) (Please type Assignee o r Attorney -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 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 WYOMING COUNTY OF CAMPBELL The foregoing instrumen as acknowI ed bef re me, a Notary Public in and for the State of Wyoming, by L G. �/1P> as f Meath LLC, on this 7' day of December, 2009. My Commission Expires: 03 -13 -2012 STATE OF TEXAS My Commission Expires: 08 -20 -2011 ACKNOWLEDGMENTS Ica Teri M. Storey WONNE MOE s Liv31YLQ— C1�f iv p`�1PglUp I Notar VERS of Comm. state Exp. 08Texas .20 -11 Yvo ne Hoevers COUNTY OF DALLAS The foregoing instrument was acknowledged before me, a Notary Public in and for the State of Texas, by David E. Lancaster, Eutive Vice President and CFO of MRC Rockies Company, on behalf of said company, on this 31 day of December, 2009. OCv393