HomeMy WebLinkAbout953390Form 3106 -14
(September 1982)
1. Assignee's Name
UNI, .;D STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
TRANSFER, ASSIGNMENT, OR SUBLEASE
OF OPERATING RIGHTS IN OIL AND GAS_LEASE.
PART 1
NORTH AMERICAN RESOURCES COMPANY, INC.
Address (include zip code)
16 East Granite
Butte, Montana 59701
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 -4)
Township 26 North, Range 111 West, 6th PM
Section 17: All
Containing 640.00 acres, more or less
Lincoln County,Wyoming.
This assignment is subject to the terms and conditions of that certain "Assignment, Bill of Sale and Conveyance"
executed by the parties hereto dated December 18, 1986, effective December 1, 1986 as recorded in the above
referenced county and state. Said assignment does not constitute any additional conveyance or assignment of
oil, gas and mineral leases, lands or interest therein described but is the same interest being conveyed by
this assignment.
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
6. Specify overriding royalty previously reserved or conveyed, if any
FORM APPROVED
OMB NO. 1004 -0034
Expires: August 31, 1989
Lease Serial No.
W -72845
Lease effective date
October 1, 1981
3.2771995
.7592590
7.505
The undersigned, as owner of 4.036458 percent of operating rights in the above- designated oil and gas lease, hereby transfers, assigns,
7. If any payments out of production have previously been created out of this interest, or if any such payments are being reserved under this
transfer, assignment, or sublease, attach statement giving full details as to amount, method of payment, and other pertinent terns 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 herein, 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.
Executed this /G 7 day of L 19 /Jbut Effective December 1, 1986
General Hydocarbons 1982X Oil G Program.
Chairman of t Assignor's Signature)
General Hydrocarbons, Inc. as Managing General Partner
ATTEST:
Approval does not warrant that either party
to this transfer holds legal or equitable
title to this lease.
Assistant Secretary (City) (State) (Zip Code)
Title 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 to b:
States any false, fictitious, fraudulent statements or representations as to any matter within its jurisdiction.
Assignment approved effective JUN 01 1987
THE UNITED STATES OF AMERICA
200 Transwestern II Building
P.O. Box 31515
Billings,
(Title)
(Assignor's Address)
MT 59107
B l i ILA '.t
(Authorized Officer)
SUPERVISOR, MAINTENANCE UNIT JUN 1 7 1987,
(Date)
reproductions on one sheet of both sides of this
official form in accord-
NOTE: This /orm may be reproduced provided that copies are exact
ancr with prov,sion.s of 43 CFR 3306.
ORIGINAL
0'6052
RECEIVED 5/12/2010 at 10:22 AM
RECEIVING 953390
BOOK: 747 PAGE: 52
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
tE
55 and CCrYlp &ranvt:, copy
l S official recur(
S on iila
fi
PART 11
ASSIGNEE'S APPLICATION FOR APPROVAL OF TRANSFER
OF OPERATING RIGHTS AND/OR OPERATING AGREEMENT (SUBLEASE)
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 q A- day of 1)1C f
NORTH AMERICAN RESOURCES COMPANY, INC. t
President (Assignee's Signature)
ATTEST:
Assistant Secretary
1. 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.
2. FILING AND NUMBER OF COPIES File three (3) completed
19(
16 East Granite
Butte
(City)
rifle 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
;fates any false, fictitious, orfraudulent statements or representations as to any matter within its jurisdiction.
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. support of nota
(2) Documentation for public information in supp
tiona 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 pu ant to the taw (43 CFR 3106- 3(c)).
This information will be used to crew record of lease assignment.
Response to this request is required t lain a benefit.
(Assignee's Address)
MT
(State)
59701
(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 alter 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 mist be furnished prior to approval of the,
assignment.
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