HomeMy WebLinkAbout890886Form3000-3
(January 1999)
4
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
9 _
PR PAGE___o 2 '[ Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.)
Act for Acquired Lands of 1947 (30 U.S.C. 351-359)
Geotherlrml'-Steam Act of 1970 (30 U.S.C. 100J - 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.
FORM APPROVED
OMB NO. 1004-0034
Expires: December 31,2001
Lease Serial No.
wyw 150469
Lease Effective Date
(Anniversary Date)
dune 1, 2000
New Serial No.
PART A: ASSIGNMENT
Assignee* Stone Energy Corporation
Street 1801 Broadway., Suite 700
City, State,ZIp_Code Denver,Colorado 8020~ 9 0 8 8 6
*lfmore than one assignee, cbeckhere [] and list file name(s) and address(es) of all
on a separate attached sheet of paper
This record title assignment is for: (Check One)
RECEIVED
LINCOLN COUNTY CLERK
[] Oil and Gas Lease, or
additional assignees on the reverse of this
.... I'!Z .........
Geothermal Le~e
form or
Interest conveyed: (Check one or both, as appropriate) [] Record Title, [] Overriding Royalty', payment out of production or other
similar
interests or payments
2. This assignment conveys the following interest:
Land Description Percent of Interest Percent of
Additional space on reverse, it'needed. Do not submit documents or agreements other than Owned Conveyed Retained Overriding Royalty
.~/ihis fom~; such documents or agreements shall only be referenced herein, or Similar Interests
Reserved Previously
Reserved
/¢/ Or conveyed
A b c d e f
ToWnship 25 North, Ranqe 112 West, 6'h P.M. 100% 50% 50% 0% of None
Section 18: Lots 1-4, W/2E/2, E/2W/2 8/8ths
Section 19: Lots 1-4, W/2E/2, E/2W/2, SE/4SE/4
Section 30: Lots 1-3, E/2, E/2NW/4, NE/4SW/4
Lincoln County, Wyoming
Containing 1,217.15 acres, more or less
Subject to the reruns and conditions of the certain Farmout Agreement, dated effective
August 1, 2000 by and between Marathon Oil Company and Basin Exploration, Inc., as
amended
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
leffal
or equitable title to this lease.
[] Assignment approved for above described lands;
Assignment approved effective
[] Assignment approved for attached land
description
[] Assignment approved for land description
indicated on reverse of this form.
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.
COUNTY OF OKLAHOMA §
The foregoing instrument was acknoWledge,d before me by , "~, ~&'~-fi, ~---~'-r~fi4~-
for MARATHON OIL COMPANY, this ~'~--4~-jday of June, 2003//'
My Commission Expires:
, as AttOrney-in-Fact
Witness my hand an~hoffidal seal.
~/£"~ Notary
.... ~: PHYLLIS A. PACE
/'~ "".. Oklahoma County
~ ~SE.,.A, L.,) ! Notary Public in and .for
\ ..~/ State of Oklahoma
..... ~.u..~.,.,," My commission expires Feb. 28, 2004.
PART B: CERTIFICATION AND REQUEST FOR APPROVAL
l. The Assignor certifies as owner Of an interest in the above designated lease tbat he/she hereby assigns to the above assignee(s) the rights specified above~
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 cbargeable interest, direct or 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 m oil and
gas options), or30 0,000 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 m 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 regulatious (43 CFR Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in
compliance with reclamation requiremants tbr all Federal oil and gas lease holdings as required by sec. 17 (g) of the Mineral Leasing Act; and (f) Assignee is
not iu violation of sec. 41 of the Mineral Leasing Act.
3. Assignee's signature to this assignmeut constitutes acceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease
described herein.
For geotbermal 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 assigmncnt is added to all previously created overriding royalties (43 CFR 3241).
1 certify that thc statements nmde herein by me are true, complete, and correct to the best of my knowledge and belief and are made in good faith.
*Effective ~twee~ayo~e Qarties Au_qust,2(~ 0~000 Executed this I~ dayof ~W nfl
Executed this -June t
,20 03
Name of Assignor
as shown on current Lease Marathon Oil Company
Assignor !:'.~ ,
or (Signatm,~[ ~
~ Attorney-in-fact
.. ", D. X~.73~b~t~' (Signature)
Expressway
(Assignor's Address)
Oklahoma City, Oklahoma 73132
Assignee
or
Attcrr,,W in Fact
Michael E. Cuba. Denver District Land Manager
(City) (State) (Zip Code)
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 t be 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, 1849C Street, N.W.
Washington, D.C. 20240.
Title 18 U.S.C. Sec. 1001 makes it a crime Ibr any person knowingly and willfully to make to any Department ~r agency of the United States any false, fictitious,
or fraudulent
statements or representations as to any matter within its jurisdiction.