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Home My WebLink About959490Land Description Percent of Interest Percent of Overriding Royalty or Similar Interests Additional space on page 2, if needed. Do not submit documents or agreements other than this form; such documents or agreements shall only be referenced herein. a Owned b Conveyed c Retained d Reserved e Previously reserved or conveyed f TOWNSHIP 24 NORTH, RANGE 112 WEST, 6 P.M. 100% 100% 0% a, 0,,o.: rr l RRJJ 0% r:: yy Any of record Section 31: Lots 1 -4, E2, E2NW Section 32: ALL Containing 1149.92 acres, more or less. Lincoln County, Wyoming RECEIVED 5/31/2011 at 12:58 PM RECEIVING 959490 BOOK: 767 PAGE: 439 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY Form 3000 -3 (May 2006) Return to: SAMSON (Kim Nazarman) Two West 2nd St. -ma.. nu- veinv_aina 1. Assignee* Street City, State, ZIP Code terest: (Continued on page 2) UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT 000439 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) Samson Resources Company Two West Second Street Tulsa, OK 74103 *If more than one assignee, check here and list the name(s) and address(es) of all additional assignees separate attached sheet of paper. This record title assignment is for: (Check one) ZOil and Gas Lease, or Geothermal Lease Interest conveyed: (Check one or both, as appropriate) Record Title, Overriding Royalty, payment interests or payments Assignment approved effective By Bureau of Land Management (BLM) Type or print plainly in ink and sign in ink. PART A: ASSIGNMENT la. Assignor Baseline Minerals, Inc. 518 17th Street, Suite 1050 Denver, CO 80202 (Title) FORM APPROVED OMB NO. 1004 -0034 Expires: April 30, 2009 Lease Serial No. WYW 178968 Lease Effective Date (Anniversary Date) May 01, 2011 New Serial No. Assignment approved for attached land description on page 2 of this form or on a out of production or other similar FOR BLM USE ONLY DO NOT WRITE BELOW THIS LINE Gi ti i. 1 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 above described lands; Assignment approved for land description indicated on reverse of this form. (Date) Part A (Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No. 1. if needed. or for Land Description In item No. 2. if needed. ACKNOWLEDGMENTS STATE OF COLORADO 1 COUNTY OF DENVER 1 The foregoing instrument was acknowledged before me this 21 day of April 20 My Commission Expires: August 15, 2014 STATE OF OKLAHOMA 1 COUNTY OF TULSA J The foregoing instrument was acknowledged before me this T) Samson Resources Company. My Commission Expires: or 1s The Assignor certifies as owner of an interest in the above designated lease that he /she hereby assigns to the above assignee(s) the rights specified above. 2. Assignee certifies as follows: (a) Assignee is a citizen of the United States; an association of such citizens; a municipality; or a corporation organized under the laws of the United States or of any State or territory thereof. For the assignment of NPR -A leases, assignee is a citizen, national, or resident alien of the United States or association of such citizens, nationals, resident aliens or private, public or municipal corporations; (b) Assignee is not considered a minor under the laws of the State in which the lands covered by this assignment are located; (c) Assignee's chargeable interests, direct and indirect, in each public domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases (of which up to 200,000 acres may be in oil and gas options), or 300,000 acres in leases in each leasing District in Alaska of which up to 200,000 acres may be in options, if this is an oil and gas lease issued in accordance with the Mineral Leasing Act of 1920, or 51,200 acres in any one State if this is a geothermal lease; (d) All parties holding an interest in the assignment are otherwise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in compliance with reclamation requirements for all Federal oil and gas lease holdings as required by sec. 17(g) of the Mineral Leasing Act and (f) Assignee is not in violation of sec. 41 of the Mineral Leasing Act. 3. Assignee's signature to this assignment constitutes acceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease described herein. For geothermal assignments, an overriding royalty may not be less than one -fourth (1/4) of one percent of the value of output, nor greater than 50 percent of the rate of royalty due to the United States when this assignment is added to all previously created overriding royalties (43 CFR 3241). I certify that the statements made herein by me are true, complete, and correct to the best of my knowledge and belief and are made in good faith. 20 11 Executed this (2,' dav of n v‘, 20 11 Name of tgnor as sho Samson Resources Company Executed this 21 dav of April (City) (Continued on page 3) day of PART B CERTIFICATION AND REQUEST FOR APPROVAL n on current leas Baseline Minerals, Inc. (Signature) 518 17th Street, Suite 1050 (Assignor's Address) Denver, CO 80202 Please type or print (State) (Zip Code) STACIE t KERBER Notary Public State of Colorado St ph W.Tham erber Votary u.lic fl 1 ►1 riqd01, 4� Notary Public Assignor /i Assignee esident (Signature) or Attorne -in -fact Attorney -in -fact 000440 rats. Inc. My Commission Expires August 15, 2014 2011. by Michael G. Daniel. Attorney -in -Fact for (Signature) ichael G. Daniel (Signature) Notary {public State of Oklahoma KIM NAZARMAN TULSA COUNTY, COMMISSION 008008960 Comm, Ex 08 -26 -2012 Title 18 U.S.C. Sec. 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 or fraudulent statements or representations as to any matter within its jurisdiction. (Form 3000 -3, page 2)