HomeMy WebLinkAbout888233 Form. 3000-3 ~ 'NITED STATES '-~
(J:/nuary 1999) DEPAk-. MENT OF THE INTERIOR
' -., ~" /~q~ ~:_~.!_(~.i}] BUREAU OF LAND MANAGEMENT '
· ' ', "];~:", f, q(~ ~""" ' ASSIGNMENT O~~ INTEREST IN A
:.?.'.~:.L'.'-: ~-'" ~ o ~SE FOR OIL AND GAS OR GEO~ERMAL RESOURCES
~ ~, ¢'. ~ .
...... ~. ~ ~A' ~ Act for Acau~ed Lands of 1947 (30 U.S.C 351-359)
~.~ L.-;,,;,/,~,{~}~ Geothermal~~~ ~.C. 1001-1025)
. ,~-;(~ ~.~'~D~;nt of the Interior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508)
FORM ........ ED
OMB NO. 1004-0034
Expires: December 31, 2001
Lease Serial No.
WY~V-134444
Lease Effective Date
(Anniversary Date)
November 1, 1994
New Serial No.
Type or print plainly in ink and sign in ink.
PART A: ASSIGNMENT
·
1. Assignee* STONE ENERGY, L.L.C. i7 *:"t' .. : , .... .-
Street 1670 Broadway, Suite 2800 ,% x.
City, State, ZIP Code Denver, Colorado 80202-4801
*If more than one assignee, check here [] and list the name(s) and address(es) of all additional assignees on the reverse of this form or on a
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, [] Overriding Royalty, payment out of production pi' other similar
interests or paymems
2. This assignment conveys the following interest:
Land Description Percent of Interest Percent of
Additional space on reverse, if needed. Do not submit documents or agreements other that Owned Conveyed Retained Overriding Royalty
this form; such documents or agreements shall only be referenced herein, or Similar Interests
Reserved Previously
reserved
or conveyed
a b c d e f
Township 24 North, Range 112 West, 6th P.M. 100.00% 50.00% 50.00% None Those of Record
Section 28: NI/2, N1/2 SEI/4
070
Containing 400.00 acres more or less. BOOK,~I L] PR P,a!GE
Lincoln County, Wyoming
RECE VED
Subject to the terms and conditions or that certain Fannout Agreement dated effective L i N C~ L_, C 0 [J IN T Y O L E R K
August 1, 2000 by and between Marathon Oil Company and Basin Exploration, Inc., as
amended 8 8 8 2 3
FOR BLM USE ONLY -- DO NOT WRITE BELOW THIS LINE
UNITED STATES OF AMERICA
~is assignment is approved solely for administrative purposes. Approval does not warrant that either party to'this assignment holds legal or
uitable title to this lease.
~[~3k\ssignment aPproved for above described lands; [] Assignment approved for attached land
description
Assignment approved effective · ~'=T'I') ti ,~ ~ _ [] Assignment approved for land description, indicated on reverse
/S/
Carmen
E. kov
By
(Authorized Officer) (Title) (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.
STATE OF OKLAHOMA )
) SS. [Wyoming Form] ~' 3 7 1
COUNTY OF OKLAHOMA )
The foregoing instrument was acknowledged before me by D.J.
Stone, Attorney-in-Fact of Marathon Oil Company, this 31st day of
December, 2001.
My Commission Expires:
February 28, 2004
Witness my hand and official seal.
Nota~f l~ublic"- .....
Phyllis A. Pace
........... PI-IYI l.IS A PACE
"'~'" Oklahoma County
Notary Public in and for
I "-...o~O .:'
I '-. grtL,..."Sta~e of Oklahoma
~ .......... My com,,;issisn expires Feb 28. 2004.
PART B: CERTIFICATION AND REQUEST FOR APPROVAL
1. 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 acrei' 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 (0 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 (¼) 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.
* Effective between the Parties August 1, 2000
Executed this ~/ day of ~O~'"%, 2001
Name of Assignor as shown on current lease MARATHON OIL COMPANY Please type or print
Assignor or
Attorney-in-fact
~~,~[S ~gnature)
'~ ~lf * D.J. STONE
7301 N. W. Expressway
(Assignor's Address)
Oklahoma Cie/', Oklahoma 73132
(City) (State)
(Zip Code)
Executed this c:~2 dayof
STONE ENERGY, L.L.C.
Assignee
,2002
or
(Signature)
* MiChael E. Cuba~
Denver District Land Manager
Public reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land
Management, (1004-0034), Bureau Clearance Officer (WO-630), Mail Stop 401 LS, 1849 C Street, N.W., Washington, D.C. 20240.
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
sta,tements or representations as to any matter within i*" Jurisdiction.
*U.S. GPO: 1999-774-004/41005
STATE OF COLORADO )
) SS.
COUNTY OF DENVER )
The foregoing instrument was acknowledged before me this 22"d day of January,
2002 by Michael E. Cuba, as Denver District Land Manager for Stone Energy, L.L.C.
Witness my hand and official seal.
My Commission Expires:
~rr~, Commission Expires 02-01-2005
372