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HomeMy WebLinkAbout869412Land Description Percent of Interest Percent of Overriding Royalty 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 herein. A Owned b Conveyed C Retained d Reserved e Previously reserved or conveyed f Township 20 North. Range 115 West. 6 P.M. 100% .5000025% (ORRI) 100% 0% 0% Section 8: E2 Section 18: Lots 1-4, E2, E2W2 Section 20: All Section 30: Lots 1 -4, E2, E2W2 Lincoln County, Wyoming Containing 2250.72 acres, more or less Form 3000 -3 (October 1992) OF f fIF 3rt.?.E.A.,U OF LAND 00 t 1 r ?l, RECEiVED CHEYENNE, WYOMING 1. Assignee* Street City, State, ZIP Code 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) Baseline Minerals, Inc. 1645 Court Place, Suite 422 Denver, CO 80202 Type or print plainly In Ink and sign In ink. PART A: ASSIGNMENT BOOK 55 PR PAGE 0 9 9 R,CEiVED *If more than one transferee, check here land list the name(s) and address(es) of all additional transferees on the r v tt�'s a5m oc,on4a sp sheet of paper. yt This transfer is for: (Check one) Oil and Gas Lease, or Geothermal LEe6 9 i 1 2 Interest conveyed: (Check one or both, as appropriate) Record Title. X Overriding Royalty, payment out of production or other similar interests or payments J E. 6\ N N L. 2. This assignment conveys the following interest: Assignment approved for above described lands; Assignment approved effective By (Authorized Officer) FOR BLM USE ONLY -DO NOT WRITE BELOW THIS LINE 00 NOV KEMMERE (Title) (Date) FORM APPROVED OMB NO. 1004 -0034 Expires: July 31, 1995 Lease Serial No WYW- 150888 Lease Effective Date August 1, 2000 ul 9:50 Assignment approved for attached land description Assignment approved for land description indicated on reverse of this form te THE UNITED STATES OF AMERICA This assignment is approved solely for administrative purposes. 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