HomeMy WebLinkAbout877045 , ~rm3000-3a UNITED STATES
· (January 1996) DEPARTMENT OF THE INTERIOR FORM APPROVED
BUREAU OF LAND MANAGEMENT OMB NO.' 1004-0034
~xpires: September 30, 1998
TRANSFER OF OPERATING RIGHTS (SUBLEASE) IN A ~ Serial No.
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
Mineral I_easing Act of 1920 (30 U.S,C. 181 et seq.) W-26565
Act for Acquh~d Lands of 1947 (30 U.$.C. 351-359)
Geothermal Steam Act of 1970 (30 U.$.C. 1001-1025)
Deparanent of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C, 6508)
TYpe or print plainly !n ink anti'sign In lng.
PART A: TRANSFER
I. Tnm~fere~(Suble~ee)* Charles E.' Strange 1976 Trust #1
S~et P O Box 1210
City, Sm~, ZIP Code Inverness, Florida 34451 -1 21 0
*If more than one transferee, check here [] and list the name(s) and address(es) of all additional transferees on the reverse of this form or on a
separate attached sheet of paper.
This transfer is for: (Check one) ~ Oil and Gas Lease, or [] Geothermal Le_ a. se
Interest conveyed: (Check one or both, as appropriate) [] Operating Rights (sublease) ~ Overriding Royalty, payment out of production or other
similar interests or payments
2.. This transfer (sublease) conveys the following interest:
Land' Desc,ription Per~-ent of Interest Percent of
~dditional space on rever~e, if needed. Do not submit documents or agreements other than' OwnedI Conveyed Rehained Oyerriding Royalty
or Similar Interests
~ form; such documents or agreements slmll only be referenced herein: Reserved Previously
or conveyed
a b c d e f
Sta'te of Wyoming, County of Lfncoln 100% 0%
T. 26 N., R. 111 W., 6th Prin. Mcr. ORR ORR
FOR BLM USE ONLY--DO NOT WRITE BELOW THIS LINE
TIIE UNlTED STATES OF AMERICA
This transfer b approved solely for aflmin~rative purposes. Approval does not warrant that either party to this transfer holds legal or equitable
[] Transfer approved effective
By
(Authorized Officer) (Title)
Item No. 1, il' needed, or lot Land Description in Item No. 2 if n~edud.
,)
PART B: CERTIFICATION AND REQUEST FOR APPR~)'~-L- .........................................
1. The transferor certifies as owner of an interest in the above desto, hated lease that he/she hereby lransfers to the above transferee(s) ~h~ rights ~peciJied above.
2. Transferee certifies as follows: (si Transferee is a citb~en ol the United States; an association of such c~tizens; a m~tucipality; ur a corpo ration c)~ ~an'iyed und'.'r the
of ihe United States or of any State or territor~ thereof. For the transfer of NPR-t\ leases, transferee is a citizen, :~atioaal, or resident alien ~,i' lhe United ,~;tales or
associations of such citizens, nationals, resident a iens or private, u' ~' ' '
· p D,~c or mumclpal corporations; (t~) Transferee i.i nol considered a rain ~r under the iaws of the SI ate
m which the lands covered by this transfer are located; lc} Transferee's chargeable ipterests, direct and indirect, i~ ~'ach public d omain and arq aired lands separ:ttely
the same State. do nOl exceed 246,080 acres in o]1 and gas teaseslofwhich up lo 200,000 acres may he in oil and gas options), r~r )00,000 acres in leases in each
District in Alaska ofwhich up lo 2~,~ acres may ~ in options, if this is an oil and gas lease issued in accordance with the N'linerai ~easing Act of 1920, or 51,20~
acres in any one State if this is a geothermal lease; and (dj All pa~ies holding an interest in the H'ans fer are otherwise in c~mpliance ~,ith the regular ides {43 CFR (;ruup
3[00 or 3200) and the authorizing Acts; (e} Transferee is in complian~ willx reclamation requirements far ali Federal oii and gas lease holdings as required ~ sec. I
of the Mineral [.easing Act; and {0 Transferee is nol in violation of sec. 41 of the Mineial [.easing Act.
3. Tr~sferee's signature to this assignment co~slitutes ac~p~ of ~1 applicable terms, conditinns, stipulations and restrictions ~rmining to the le~se descri~ herein.
Applicable te~s ~d conditions include, but a~ n~ limit~ m, an ~ligation to conduct all o~ration~ on the leasehold in accordance with the {enns and cm:dili~ms of
the lease, to condition all wells Mr proof ab~don~nt, to ~9~ t~ I~ed I~ u~n completion of any o~rations as described in the lease, and h) Mrnish and mainlain
such ~nd as ~y ~ ~ui~ by ~ l~or ~n~t 1o ~ 43 CFR 31~, 3134, or 32~.
For geothe~al transfer, an ove~ding royal~ ~y nm ~ l~s ~n ~-fou~ (M) of one ~rcent of the value of output, nor greater than 50 ~rcent of the rate of royalty
due to the Unit~ Stoma when ~is ~nsfer is ad~ to all p~vimmly c~ ovemding royalties (43 CFR 3241).
I ce~i~ ~t ~e smta~n~ m~ ~rein by ~ ~ ~, ~mp~, ~ ~t m ~ ~st of my ~owledge and ~lief and are made in g~ t~ith.~
~~ ~Rth ~ October ,~'_ ~00~ ~c~m~ 18th ~yofOct°ber ,~2001
N~ofT~,f~r ~har~, Stranq~.
or- '[3i~mm~) '~ -c ~ Charles E. Strange 1976 Trust ~1
~~ Charles E. Strange, Jr. ~-~//!~¢-e.~ ~(~~
P O Box 237 ~ · ' (Sig~) ? -
Monica Haufler, Trustee
HoZde~ ~PZor~d~ ~444S -- NG EM~
BURDEN HO~ .... ~
~blic rc~ng bur~n for th~ f~ is es~m~d to a~e ~ mm~s ~ rm~nsc includm~ ~e time for reviewing instmctien~, ~a~edng ~nd m~imng da~a, ~d
completing ~d reviewing t~ f~m. D~t ~nts reg~ ~ ~n cs~ma~ or any o~er aspect of t~s J'om~ to U.S. Depa~r~nt of ~e interior, Bmeau of L~d
M~emenL Bureau Cle~ce Officer (DW-110), D~v~ ~ ~mer, Buil~ng 40, P.O. Box 25047, Denver, CO 80225-0047 and the Office of Ma~gemmt ~d
B~g~, P~mork Redu~ion Pro, ct (1~34), W~Mngton. D.C. ~503.
Title 18 U.S.C. ~. 1~1 ~kes it a cfi~ for any ~r~n ~owingly ~ willMlly to ~ke to any Department or agency of the United States any false, fictitious or
.am~nts or re~nmti~ ~ lo ~y rorer wi~m i~ j~i~i~.
0 0 3,
ACKNOWLEDGEMENT
STATE OF FLORIDA)
)ss
COUNTY OF CITRUS)
Personally appeared before me the undersigned authority, the within
named Charles E. Strange, Jr. and Monica Haufler, trustee of the Charles E.
Strange 1976 Trust #1, known to me to be the persons whose names are
subscribed to the foregoing instrument and acknowledged before me that they
executed the same for the purposes and consideration therein expressed, in the
capacity therein stated.
GIVEN UNDER (WITNESS) MY HAND AND SEAL OF OFFICE THIS
THE 18TH DAY OF OCTOBER 2001.
My commission expires:
~~~ -- Residing in Citrus Count, Florida