HomeMy WebLinkAbout870485Form 3000 -3
(October 1992)
91 AUG i-1 9: 00
RECE
via i t 17�a it�t
1. Assignee*
Street
City, State, ZIP Code
*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) Oil and Gas Lease, or Geothermal Lease
Interest conveyed: (Check one or both, as appropriate) Record Title,
2. This assignment conveys the following interest:
Celsius Energy Company
1331 17th St., Suite 800
Denver, CO 80202
0
Percent of Interest
Owned
b
100%
��4w y l:.
lr avid 4 ±ri4`,
;iliCi. l revue
F LAND
Conveyed
c
?rativn copy
is on silo
009
50%
\NAGEME
Retained
d
yT
50%
G
Reserved
e
5.5%
1NAL
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.
a
Township 19 North, Range 113 West, 6th P.M.
Section 32: NE4
Containing 160 acres, more or less
Lincoln County, Wyoming
FOR BLM USE ONLY —DO NOT WRITE BELOW THIS LINE
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 attached land description
SEP 01 1997
Assignment approved effeaive
..;7
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)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
to be tr
of illy.
87848 J
FORM APPROVED
OMB NO. 1004 -0034
Expires: July 31, 1995
Lease Serial No.
WYW- 134456
Lease Effective Date
(Anniversary Date)
11 -1 -94
New Serial No.
BOO �Jd PR PACT; 5 r l
r
LItcoLPii COUNTY C
on the reverse
JEANNE IVY ,r C? IVY KEMMERER
Overriding Royalty, payment out of production or o er Slclilar
interests or payments
Percent of
Overriding Royalty
or Similar Interests
Previously
reserved
or conveyed
–0–
Assignment approved for land description indicated on reverse
of this form.
LAND LAW EXAMINER DEC 1 7 1991i
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