HomeMy WebLinkAbout872241Land Description
Percent of Interest
Percent of e
Overriding Royalty ,i
or Similar Interests
Additional space on reverse, if needed. Do not submit documents or agreements
other than this form; such documents or agreements shall only be referenced
herin.
k a
Owned
b
Conveyed
c
Retained
d
Reserved
e
Prev usly
reserved
or conveyed
f
Township 23 North, Range 114 West. 6 P.M.
100.00%
100.00%
I
None
RECEIVED
MOLL 1`) C+lUNT'(
aF, �1
cat c1�; pl
iCr hltt F f,E
None
CLERK+
r; 31
'17 y�
WYOMING
None
Section 20: N1/2, SW1 /4
Section 28: W1/2W1/2
Section 29: W1/2W1/2
Containing 800.00 acres more or less
Lincoln County, Wyoming
BOOK 461 PR PAGE 2
����4
Forth 3000-3
(January 1996)
1. Assignee
Street
City, State, ZIP Code
This record title assignment is for: (Check One)
2. This assignment conveys the following interest
By
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.C. 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. 6508)
Tom Brown, Inc.
555 17 Street, Suite 1850
Denver, CO 80202-3918
*If more than one assignee, check here and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a separate
attached sheet of paper.
(Authorized Officer)
Interest conveyed: (Check one or both, as appropriate) Record Title,
Assignment approved for above described lands;
Assignment approved effective
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
Oil and Gas Lease, or Geothermal Lease
FORM APPROVED
OMB NO. 1004 -0034
Expires: September 30, 1998
Lease Serial No.
WYW 152280
Lease Effective Date
(Anniversary Date)
February 1, 2001
New Serial No.
Overriding Royalty, payment out of production or other similar interests
or payments
rvr� o�m vas vn�1.r uv nv YYRI I C OCLVYY 1171) LIIVC
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 to this lease.
Assignment approved for attached land description
Assignment approved for land description indicated on
reverse of this form.
(Title)
(Date)
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