HomeMy WebLinkAbout953391Form 3106 -14
(September 1982)
1. Assignee's Name
TRANSFER, ASSIGNMENT, OR SUBLEASE
OF OPERATING RIGHTS IN OIL AND GAS LEASE
NORTH AMERICAN RESOURCES COMPANY, INC.
Address (include zip code)
16 East Granite
Butte, Montana 59701
The undersigned, as owner of 12.5000 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 -4)
Township 26 North, Range 111 West 6th PM
Section 5: Lot 4 (39.84), S2NW4, SW4
Section 6: Lot 1 (39.83), SE4NE4, E2SE4
Section 8: SE4SW4
Containing 479.67 acres, more or less
Lincoln County, Wyoming
Surface down to the stratigraphic equivalent of 9,440 feet, as encountered
in the Hanson Federal 40 -6 Well, NE4SE4 Section 6, T26N, R111W.
RECEIVED 5/12/2010 at 10:23 AM
RECEIVING 953391
BOOK: 747 PAGE: 54
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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
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 terms as
provided under 43 CFR 3106.
it is agreed that the obligation to pay any overriding royalties or 8ayments out of production of oil created tietein, 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 7 day of
Y 19rS9 but Effective December 1, 1986
GeneralHydroc rbons 1982X Oil Ga Program.
200 Transwestern I1 Building
C P.O. Box 31515
Chairman of C [Assignor's Signature) (Assignor's Address)
General Hydrocarbons, Inc. as Managing General Partner
ATTEST:
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
States any false, fictitious, fraudulent statements or representations as to any matter within its jurisdiction.
Assignment approved effective
JUN 0 1 1987
i si,. t ef t f that eithet party
^g
holds legal or equitable
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
PART
Billings,
THE UNITED STATES OF AMERICA
By
FORM APPROVED
OMB NO. 1004 -0034
Expires: August 31, 1985
Lease Serial No.
W 72845
Lease effective date
October 1, 198:1
NT 59107
(Authorized Officer)
BUREAU. U LA D MANAG
10.148747%
2.351253%
0
7.5%
€it'PEsM;23C< r M .iNITE4ANCE UNET JUN 1 7 1987,
(Title) (Date)
NOTE: This form may he reproduced provided that copies are exact reproductions on one sheet of both sides o/ this official /orm in accord-
ance u mth prni isions of 43 EEC 3106. CF?Tan \T Lq T
d'sm -tom
CERTIFIED
to be a true and.comparative copy
of the official records on file
AP
O.054
1 4 2010
executed this L day of `I)
NORTH AMERICAN RESOURCES COMPANY, INC. a
A 7 7 G2
President (Assignee's Signature)
ATTEST:
Assistant Secretary
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
PART II
ASSIGNEE'S APPLICATION FOR APPROVAL OF TRANSFER
OF OPERATING RIGHTS AND.'r1R 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.
INSTRUCTIONS
NOTICE
AUTHORITY: 30 U.S.C. et. seq.
16 East Granite
Butte
(City)
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.
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 lends 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.
Che 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)).
['his information will be used to create a record of lease assignment.
tesponse to this request is required to ob'. n a benefit.
(Assignee's Address)
MT
(State)
59701
(Zip Code)
'itle 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
tates any false, fictitious, or fraudulent statements or representations as to any matter within its jurisdiction.
and manually signed copies in the appropriate BLM office. A
$25.00 nonrefundable filing feemust 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.
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