HomeMy WebLinkAbout953389Form 3106 -14
(September 1982)
1. Assignee's Name
UNI i ED STATES
DEPARTMENT OF THE IN WAIL t jjr lji i "Ta %iOR
BUREAU OF LAND MANA tp,T'pc MI t 11P;
ti 1 I
TRANSFER, ASSIGNMENT, OR S $LS,E A ft 9: 30
OF OPERATING RIGHTS IN OIL AN 5 E,J� IEA5IE
PART I
SEE EXHIBIT "A" attached hereto and made a part hereof
Address (include zip code)
SEE EXHIBIT "A" attached hereto and made a part hereof
The undersigned, as owner of 12.5 percent of operating rights in the above- designated oil and gas lease, hereby transfers, assigns,
and /or subleases to the assignee shown above, the operating rights in such lease as specified below.
2. Describe the lands affected by this transfer, assignment, and /or sublease (43 CFR 3101.2 -3 or 3101,1 -41
Township 26 North, Range 111 West, 6th P.M.
Section 17: All
Containing 640 acres, more or less,
Lincoln County, Wyoming.
RECEIVED 5/12/2010 at 10:22 AM
RECEIVING 953389
BOOK: 747 PAGE: 46
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
3. Specify interest or percent of operating rights being conveyed to assignee
4. Specify interest or percent of operating rights being retained by assignor
5. Specify overriding royalty interest being reserved by assignor
Executed this
AT
day of
SEP Y385
tAssignor's Signature)
H. Chestnut, President
John Van Heuvel Assistant Secretary
Assignment approved effective OCT.. 1 1R
13
THE UNITED STATES OF AMERICA
Lease Serial No.
L se effective date
October 1, 1981
54 of 5 /6ths;
6. Specify overriding royalty previously reserved or conveyed, if any 2% of8 la 7.5% of 8 /8ths
7. If any payments out of production have previously been created out of this interest, or if ArV'sr rt p aymenrs are being reserved under this
transfer, assignment, or sublease, attach statement giving full details as to amount, method of payment, and other pertinent terms as
provided under 43 CFR 3106.
It is agreed that the obligation to pay any overriding royalties or payments out of production of oil created Iiefein, which, when added to
overriding royalties or payments out of production previously created and to the royalty payable to the United States, aggregate in excess of
17 1/2 percent, shall be suspended when the average production of oil per well per day averaged on the monthly basis is 15 barrels or less.
I CERTIFY That the statements made herein are true, complete, and correct to the best of my knowledge and belief and are made in good faith.
,19 GENERAL HYDROCARBONS, INC.
P. 0. Box 31515
(Assignor's Address)
Billings, Montana 59107 -1515
(City) (State)
Sublette Cuc.;:.: (WY -466)
FORM APPROVED
OMB NO. 1004 -0034
Expires: August 31, 1985
12.5%
None
None
(Zip Code)
e` 18 U.S.C., Section 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, fraudulent statements or representations as to any matter within its jurisdiction.
Chief, Oil
Gcys SRcti
(Title)
(Authorized Officer)
/AND
1'11
007 2 2 IRO(
(Date)
NOTE: This %orrn may he reproduced provided that copies are exact reproductions on one sheet of both sides of this official ryn .i y ayg�.rui
ance with provisions of 43 CFR 3106. ''GGii�l bbdd YYaa
000046
to CERTIFIED
r f �if the official records on file
PR 2 t 2
A. ASSIGNEE CERTIFIES THAT the assignee and all other parties in interest (as defined in 43 CFR 3100.0 -5(b)) in this as-
signment are:
1. Citizens of the United States or qualified alien stockholders in a domestic corporation; association of the United States;
or any State or Territory thereof; or municipalities.
2. Of the age of majority in the State where the lands to be assigned are located.
3. In compliance with the acreage limitation set forth in 43 CFR 3101.1 -5 and 3101.2 -4.
B. ASSIGNEE AGREES That, upon approval of this transfer of operating rights and /or operating agreement (sublease) by the
authorized officer of the Bureau of Land Management, he will be bound by the terms and conditions of the lease described
herein as to the interests covered by this assignment, including, but not limited to, the obligation to conduct all operations
on the leasehold in accordance with the terms and conditions of the lease, to condition all wells for proper abandonment,to
restore the leased lands upon completion of any drilling operations as prescribed in the lease, and to furnish and maintain
such bond as may be required by the lessor pursuant to the regulations (43 CFR 3104.2).
C. IT IS HEREBY CERTIFIED That the statements made herein are true, complete, and correct to the best of undersigned's
knowledge and belief and are made in good faith.
Executed this
ASSIGNEE'S APPLICATION FOR APPROVAL OF TRANSFER
OF OPERATING RIGHTS AND /`1R OPERATING AGREEMENT (SUBLEASE)
day of S°P t 4 1985
(Assignee's Signature)
Wayne H. Chestnut, President
ATTEST:
I. USE OF FORM Use only for assignment of operating rights
including working interests) in oil and gas leases. If transfer
of operating rights is accompanied by an operating agreement,
a single copy of such agreement must be submitted with the
assignment. If more than one transfer of operating rights is
made out of a lease, a separate instrument of transfer is
required for each assignment. A separate instrument of assign-
ment shall be used for each lease out of which an assignment
is made.
PART 11
41r 9o` 'V6L
Tobn Van Hanvelen Accigtant Secretary
ritle_ U.S.C., Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United
itates any false, fictitious, orfraudulent statements or representations as to any matter within its jurisdiction.
INSTRUCTIONS
FILING AND NUMBER OF COPIES File three (3) completed
19
NOTICE
The Privacy Act of 1974 and the regulation in 43 CFR 2.48(d)
provide that you be furnished the following information in
connection with information required by this assignment and
request for approval.
AUTHORITY: 30 U.S.C. et. seq.
PRINCIPAL PURPOSE Tne information is to be used to
process the assignment and request for approval.
ROUTINE USES:
(1) The adjudication of the assignee's rights to the land or
resources.
(2) Documentation for public information in support of nota-
tions made on land status records for the management,
disposal, and use of public lands and resources.
(3) Transfer to appropriate Federal agencies when concur-
rence is required prior to granting a right in public
lands or resources.
(4)(5) Information from the record and /or the record will be
transferred to appropriate Federal, State, local or
foreign agencies, when relevant to civil, criminal or
regulatory investigations or prosecutions.
EFFECT OF NOT PROVIDING INFORMATION —If all the in-
formation is not provided, the assignment may be rejected.
The Paperwork Reduction Act of 1980 (44 U.S.C. 3501 et seq.) requires as to inform you that
This information' is being collected pursuant to the law (43 CFR 3106- 3(c)).
This information will be used to create a reco^d of lease assignment.
Respe ,se to this request is required to obtai benefit.
GENERAL HYDROCARBONS 1982 OIL AND GAS
PROGRAM by
General Hydrocarbons, Inc., Managing
General Parrnar
(Assignee's Address)
P. 0. Box 31515
Billings, Montana 59107 -1515
(City)
(State) (Zip Code)
and manually signed copies in the appropriate BLM office. A
$25.00 nonrefundable filing fee must accompany this assignment.
File assignment within ninety (90) days after date of final
execution.
3. EFFECTIVE DATE OF ASSIGNMENT The assignment, if
approved, takes effect on the first day of the month following
the date of filing of all required papers. If an operator's bond
is required, it must be furnished prior to approval of the,
assignment.
000047
A. ASSIGNEE CERTIFIES THAT the assignee and all other parties in interest (as defined in 43 CFR 3100.0 -5(b)) in this as-
signment are
1. Citizens of the United States or qualified alien stockholders in a domestic corporation; association of the United States;
or any State or Territory thereof; or municipalities.
2. Of the age of majority in the State where the lands to be assigned are located.
3. In compliance with the acreage limitation set forth in 43 CFR 3101.1 -5 and 3101.2 -4.
B. ASSIGNEE AGREES That upon approval of this transfer of operating rights and /or operating agreement (sublease) by the
authorized officer of the Bureau of Land Management, he will be bound by the terms and conditions of the lease described
herein as to the interests covered by this assignment, including, but not limited to, the obligation to conduct all operations
on the leasehold in accordance with the terms and conditions of the lease, to condition all wells for proper abandonment,to
restore the leased lands upon completion of any drilling operations as prescribed in the lease and to furnish and maintain
such bond as may be required by the lessor pursuant to the regulations (43 CFR 3104.2).
C. IT Is HEREBY CERTIFIED That the statements made herein are true, complete, and correct to the best of undersigned's
knowledge and belief and are made in good faith.
Executed this
ASSIGNEE'S APPLICATION FOR APPROVAL OF TRANSFER
OF OPERATING RIGHTS AND 'rtR OPERATING AGREEMENT (SUBLEASE)
day of
(Assignee's Signature)
Wayne H. Chestnut, President
ATTEST:
lX( 1, /l /2(t c.:
ohn B. Van Heuvelen, Assistant Secretary
1. USE OF FORM Use only for assignment of operating rights
(including corking interests) in oil and gas leases. If transfer
of operating rights is accompanied by an operating agreement,
a single copy of such agreement must be submitted with the
assignment. If more than one transfer of operating rights is
made out of a lease, a separate instrument of transfer is
required for each assignment. A separate instrument of assign-
ment shall be used for each lease out of which an assignment
is made.
2. FILING AND NUMBER OF COPIES File three (3) completed
PART II
19
INSTRUCTIONS
NOTICE
The Privacy Act of 1974 and the regulation in '43 CFR 2.48(d)
provide that you be furnished the following information in
connection with information required by this assignment and
request for approval.
AUTHORITY: 30 U.S.C. et. seq.
PRINCIPAL. PURPOSE Tne information is to be used to
process the assignment and request for approval.
ROUTINE USES:
(1) The adjudication of the assignee's rights to the land or
resources.
(2) Documentation for public information in support of nota-
tions made on land status records for the management,
disposal, and use of public lands and resources.
(3) Transfer to appropriate Federal agencies when concur-
rence is required prior to granting a right in public
lands or resources.
(4)(5) Information from the record and /or the record will be
transferred to appropriate Federal, State, local or
foreign agencies, when relevant to civil, criminal or
regulatory investigations or prosecutions.
EFFECT OF NOT PROVIDING INFORMATION If all the in-
formation is not provided, the assignment may be rejected.
The Paperwork Reduction Act of 1980 (44 U.S.C. 3501 et seq.) requires us to inform you that:
This information is being collected pursuant to the law (43 CFR 3106- 3(c)).
This information will be used to create a record of lease assignment.
Response to this request is required to obtain a benefit.-
GENERAL HYDROCARBONS 1982X OIL AND GAS
GAS PROGRAM by
General Hydrocarbons, Inc., Managing
General Partner
(Assignee's Address)
P. 0. Box 31515
Billings, Montana 59107 -1515
(City)
(State) (Zip Code)
ritle 18 U.S.C., Section 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, orfraudulent statements or representations as to any matter within its jurisdiction.
and manually signed copies in the appropriate BLM office. A
$25.00nonrefundabie filing fee must accompany this assignment.
File assignment within ninety (90) days after date of final
execution.
3. EFFECTIVE DATE OF ASSIGNMENT The assignment, if
approved, takes effect on the first day of the month following
the date of filing of all required papers. If an operator's bond
is required, it must be furnished prior to approval of the
assignment.
^J
000048
EIR
true and comparative copy
the official records on file
PR 2 va 2
D MANAGEMENT
KNOW ALL MEN BY THESE PRESENTS:
THAT GENERAL HYDROCARBONS, INC., a Minnesota corporation of
200 Transwestern II, P.O. Box 31515, Billings, Montana 59107 -1515,
hereinafter referred to as "Assignor: for and in consideration of the
sum of Ten Dollars ($10.00) and other valuable considerations, the
receipt and sufficiency of which is hereby acknowledged does hereby assign,
transfer, set over and convey unto:
General Hydrocarbons 1982 Oil
and Gas Program
200 Transwestern II Building
P.O. Box 31515
Billings, Montana 59107 -1515
General Hydrrcarbons 1982X Oil
and Gas Program
300 Transwestern II Building
P.O. Box 31515
Billings, Montana 59107 -1515
EXHIBIT "A"
To that certain Assignment of
Record Title in Oil and Gas
Lease Number W- 72845, dated
t P J P ae-� ate. /9' 1984
an undivided 8.4635421
an undivided 4.036458%
4J
O' J O49
ER IFIED
to be rue and comparative copy
the official records on f
EAU OF L D MANAGEMEN"
STATE OF MONTANA
COUNTY OF YELLOWSTONE
GENERAL HYDROCARBONS, INC.
ss.
BEFORE ME, the undersigned authority, in and for said county and state,
on this day personally appeared WAYNE H. CHESTNUT, known to me to be the
person and officer whose name is subscribed to the foregoing instrument
and acknowledged to me that the same was the act of the said General Hydro—
carbons, Inc., a corporation, and that he executed the same as the act of
such corporation for the purposes and consideration therein expressed, and
in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE THIS day of
1984.
Notary Public
Jo Ann Uukart
NOTARY
PUBLIC, for o IiiLlizona
My Commission Expi
to be a
of t
C)
cv
cn
Ln
rn
N)
C� 4-n rrt
RTIFIED
e and comparative copy
official records on file
R 2 20
A S F LAI, MANAGEMENT
STATE OF MONTANA
ss.
COUNTY OF YELLOWSTONE
On this day of 19 before me, a
Notary Public, personally appeared WAYNE H. CHESTNUT, to me personally known,
who, being by me duly sworn, did acknowledge before me under oath that he is
the President of General Hydrocarbons, Inc., the corporation that is the
general partner of the partnership named in the foregoing instrument, that he
executed said instrument on behalf of said corporation by the authority of its
Board of Directors, and that said instrument is the free act and deed of said
corporation as said general partner.
NOTA:I PUBLIC for the `;'.r,'.:.
aes;ding at IiiiliLgs,
My C011113ai SiOil Expires A..
NOTARY PUBLIC Jo Ann Dukart
NO ARY PUBLIC Jo Ann Dukart
GENERAL HYDROCARBONS 1982 OIL AND GAS PROGRAM
A Montana Limited Partnership
My commission expires
00k3
fl
L.-- i i
s mo r~ {'t'"
GENERAL HYDROCARBONS 1982X OIL AND GAS PRO w
A Montana Limited Partnership W
STATE OF MONTANA
ss.
COUNTY OF YELLOWSTONE
On this day of 19 before me, a
Notary Public, personally appeared WAYNE H. CHESTNUT, to me personally known,
who, being by me duly sworn, did acknowledge before me under oath that he is
the President of General Hydrocarbons, Inc., the corporation that is the
general partner of the partnership named in the foregoing instrument, that he
executed said instrument on behalf of said corporation by the authority of its
Board of Directors, and that said instrument is the free act and deed of said
corporation as said general partner.
NOTATY PUBLIC for the State of RI €a =.;tano.
Etesidiritt at Billings, 1
My Cozzonision Expires Aug. 6, :997
My commission expires
ERTIFIED
to he +frue�znd :,ompirativn copy
e official records on file
MANAGEMENT