HomeMy WebLinkAbout961202Form ;e ".3
(Octobtr 1992)
1. Assignee*
Street
CERTIFIED.
to be of the official records on file copy
fice
2. This assignment conveys the following interest:
(y
e OG
(Autho ed Officer)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
i ASSIGNMENT OF RECORD TITLE INTEREST IN A
•6\LiEa4SE 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)
Type or print plainly In ink and sign In ink.
PART A: ASSIGNMENT
CABOT OIL GAS CORPORATION
15375 Memorial Drive
City, State, ZIP Code Houston, TX 77079
Land Description
Additional space on reverse, if needed, Do not submit documents or agreements other than
this form; such documents or agreements shall only be referenced herein.
MASS TRANSFER See Exhibit "A" attached hereto
Tear PART C: GENERAL
Assignor/Assignee(s) must complete Pans A I and A2 and Pan B. All panics to
assignment must sign as follows: The assignor(s) must manually sign 3 original
copies and the assignee(s) must manually sign at least 1 of the 3 original copies.
File three (3) completed copies of this fomt in the proper DLM office for cuch
assignment of record title. For a transfer of overriding royalty interest payment
not of production or other similar interest or payment, Ole one (I) manually signed
copy of this form. The required filing fee (nonrefundable) must accompany the
assignment. File assignment within ninety (90) days after date of execution of
assignor
Separate tun„ must be used tor each 'ease being affected by this assignment and
for each type of interest conveyed,
In Item No. 2 of Pan A, describe lands affected (Sec 43 CFR 3106. 3135, or
3241). For columns b, c, d, and e, enter the interest expressed as a percentage
of total interest in the lease; c.g., if assignor assigns one gunner of a 20% in-
terest, enter 20% in column b, 5% in column c, and 15% in column d.
If assignment Ss to more than one assignee, enter each assignee's name across
columns d. e, and f next to the respective interest being conveyed. Also list names
and addresses of any additiotwl assignee(s) on reverse of this form or on n separate
attached sheet of paper.
100% or None
assignors'
record
title
interes
491 VI
yip S
FORM APPROVED
OMB NO. 1004 -0034
Expires: July 31, 1995
Lease Serial No.
MASS TRANSFER
Lease Effective Date
(Anniversary Date)
MASS TRANSFER
New Serial No.
MASS TRANSFER
*If more than one assignee, check here D and list the name(s) and address(es) of all additional assignees on the reverse of this form or on n
separate attached sheet of paper.
This record title assignment is for: (Check one) IX (Oil and Gas Lease, or 0 Geothermal Lease
Interest conveyed: (Check one or both, as appropriate) Record Title, 0 Overriding Royalty, payment out of production or other similar
interests or payments
Percent of Interest
Owned
b
Conveyed
c
L
Retained
d
Pere
Overridi
or Simil
Reserved
ent of
tg Royalty
r Interests
Previously
reserved
or conveyed
None Subject; to
burdens of
record
AU 31 11
RECEIVED 9/28/2011 at 4:11 PM
REQIJEST FOR APPROVAL I RECEIVING 961202
,j BOOK: 773 PAGE: 491
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
FOR BLM USE ONLY—DO NOT WRITE BELOW THIS LINE
UNITED STATES Op AMERICA
lids assignment is approved solely for administrative purposes. :quitable title to tills lease.
Approval does not warrant that either party to this assignment holds legal or
3 Assignment approved for above described lands;
ssignment approved effective 1.'W
0 Assignment approved for attached land description
0 Assignment approved for land description indicated on reverse
of this form.
Chief, Leasable Minerais Section
(Title)
INSTRUCTIONS Teas
5. finny payment out of production or similar interests, arrangements or payments
have previously been created 0111 of the interest being assigned, or if any such
payments or interests are reserved under this assignment, include a statement giving
full details as in amount, method of payment and other pertinent terms as provided
under 43 CFR 3106, 3135, or 3241.
6. The lease account must be in good standing before this assignment can be ap-
proved as provided under 43 CFR 3116 and 3241.
7. Assignment. if approved, takes effect on the first day of the month following the
date of tiling in the proper FILM office. 11 a bond is necessary, it must be fur-
nished prior to approval of the assignment,
11. Approval of assignment of record tide to 100% of a portion of the leaser lands
creates separate teases of the retained and the assigned portions. but does not change
the terms and conditions of the lease anniversary date for purposes of payment
0) annual rental.
9. Overriding royalty, payment out of production or other similar,typcs of transfers
MUM be filed with ILM, but will be accepted for record purposes only. No offi-
cial approval will be given.
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Part A ICOnilisued): AtairnoNAL. sPace for Names and addresses of addition
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ASSIGNORS: RS:
ptsilydlertityPttilit at" made herein by me
n, nikarowitedgirlandsbelief :arid are made in good faith
t o the best of m
1,*1±3 ?ov.p. oqs
ExeCnted 'this c? day cif
but for all puAinsinbRatinioVAtigBittl.
ST ;MARY LAND EXPLORATION COMPANY
6 1
4 2
Milem Randolp Thar°, Vice President; Land
1776 Lincoln Street, Suite 1100
Denver, CO 80203
Mineral Leasing Act.
of
.J t,,, ii .Nif. t.:;;;.:, 1, ,,,..4... A 1 -.Li;
x ecuted this a 1 day of 199
for all purposes as ofAugps t 1
i
1996 7:00 4.m.
I; 1
Ralph H. Smith
7060 SOuth Yale, Suite 800
Tulsa L, OK 7411
AsSig 6
PART B: CER.LIFLCATION; OESlit FOR ARFROVAL
1'
nee
followsi ii)Assignee Is Cili1.66 of Mel toiled Stamm no amocholoi o such a moo r
I. The Assignor certifies an planer of an interest In the above dealgoz led lease ditt hcli1 h here y assigns to:die shove iiiik earl righ,a.speced a b OVA.
.1 lei ali' or a corporAtforAtiiiied soder 1
t '•••1 1.' li 1
Stale or terrlinre thereiif..For the t of•14Plt.klases, assignee is clilres.'iationol, or res{deaFrillatimf 'tic !Jolt,
or'munici al O
crporstion s, th)-Assigi+e ii.QiiiifitiosIderiulOraniloOr soder I
eer--loleaals,pahlic.40Mela a
or 1.4 ale p tdi„t;
fisliOss miffs. est mis p
otherwise li eoinpilleee'Vritli4be (41 CFR Group 3100 fOrBiArariii01616607+Lille-A.C466-tt)-A*61.gi“ 15'11 compIlaime
atisritinicovare t
docatcda.011.A elippee s *Frani! isl4rAsIs
lo-01 laisiskiirvTch 5iif 20-01.0601ae ma
ies y.hetiml,41,49., gii,• opt oas).
V-2.11511tadirtigedlieltniiii; stba Rigs rIcri" n-Aiaelta-uf4Idelt zpit 00-acies yllet4afbpthatts;irtls nap II ii efilsaeail accorden
reCiataad
AMC111
a go sip ineumems-soule oo ;oat txcee. 440,61
it; She hfiaeraiTi..e; I si'ame State trials is II TeTic";cdIMITInlIes'n4“" g 4 P AMAAC 's..It
liAj9Weiiiintialt4itigIVederal pUitroikgarnigaseMidings as revired bY sec. 17(gliillAii;b4iiiiratil:Casing Am: and rfj Assignee IS nor iii-aaiirdit cc. 41 of
b .r
ASsl'gri.ei.S;Ignaftir asitTiles'icre'c'ptinVe 'terms •ciiiiiiiiiuis,stipulaiions and lestrictioris pertaining to the lease dew
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1 al h toed Stales when this assignment is added to all previous rs
ly cai o 6 ;1
a:true, complete. and correct to the tICNI of my
know and belief and are made in good (Milt
411 "fcertify that thenkt4n1Plne.,01
3 1",01.i.t.i01•;‘
OVilita or
19 Executed this day of
okr-;:U :;1 effective for a3.1 pur es as
Executed this
sEg...f.0.3QvF.
Sarni of Assignor as.shown iso corrals
Assignor ...:+r,0,- re'k•• i
3.
CIT .136.1'..:1); g' 'i';. .-6 ':_t'l By
SEE ABOVE 11 04f0
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11 Al10611CY-in-fact ri.,lira rl ACK'. •!'4.
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SEE ABOVE
ATTORNEY-INFACtif
1:0.10,-7:C■.:,...r„,fwork 2. VI( Ii;OKN
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(Assignor's Address) 11..
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Reduction Project. lo11.1 -0034). Wishin slon A
Tulip(' reporting hMilenifir4his form is ettimated to average 30 minutes per response. Including the lime for revitwtog iidietiona-nrsintninis
and completing and reviewriiirrhe form. 131reci eik-raii4rirr‘eriigifiding ilseJkiiirdoriumerigsupjOulmjher 01 this form to ll.Sipepurimeni.:of the Interior, 11u
Tide 181J.S.C. Sec. 1001 makes it a crone for person knowingly and willfully to make to any Monument or agency of the tioitcdtates any ral4O. fictitious or fru
osuolents or representations 11 to any matte hin its jurisdiction.
CERTIFIED
to be a true and Comparative copy
of the;officiaiTecords on file
BUREAU OF LAIqbMANAG
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