HomeMy WebLinkAbout891165 UNIIED STALES , BOOK. ~J~ ~- ') PR PAGE._s~
DEPARTMENT OF 'TILE IbrrERIOR
BUREAU OF LAND MANAGEMENT
TRANSFER OF OPERATING RIGHTS {SUBLEASE} IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
Mineral Leasing Acl of 1920 f,30 U.S.C. 181 et seq.)
Act for Acquired Lands of 1947 (30 U.S.C 3.51-35t))
Oeothermal Siesta Act of 1970 (30 U.S.C. 1001-1025}
DePartment of the Inlerior Appropriations Act, Fiscal Year 1981 (42 U.S.C. 6508)
FORM APPROVED
OMB NO. 1004-0034
Expires: October 3 I, 2004
Lease Serial No.
W-0319572
October 1, 1965
Type or print plainly I. Ink and sign I. Ink.
PART A: TRANSFER
'rra.sre.,e(Sub~essee)' BELD OIL & MINERALS CO.
Sheet 1738 South Poplar Street
sep~teattachedsheetotpap~ ..........0~ I ~ ~
Ihisa~srerisrm:(Checkone) ~ Oil and Oas Lease, or ~Oeothe~alLease "'' ' ~'J" [--' r"~ ' '' '
Interest conveyed: ~hec~ one or both, ~v appropriate) ~Operating Righls (sublease) ~ ~e~ding Royal~, payment out or production or o~er
simJl~ interests or payments
2. lhis transfer [sublease) conveys the Following interest:
Land Description ' Percent of [nte~est Percenl or
A dflidonal ~sce on reverse, il' .~ded. Do not submit d0tuments 0r agreements other than Owned Conveyed Relalned Overriding Royalty
Simihu lhteresis
Ibis form; such documenls or sgreemenls shall only be referenced herein.
TRACT' I 8. 1257, TRACT [I 12. 570 Reserved Previously
ToWflgh±p 22 North, Range 113 West, 6th P.H reserved
· Or COB
TRACT I
Section 1: 'Lot 7,'W½SE~ 8.1257, 8.12570 -0- -0- /4.6625~
Sect±on 12: Lots 1,2,3, S½NW~, NE~Sw~,W½E½
TRACT II
Sect±on 1: SW~ 12.57, 12.570 -0- -0- 8./4125~
S~ct±on 12:
Containing 719.66 acres more or less, L±nco2in CountS, WY
Limited to operating r±ghts from the surfac~ of the earth tc the st:'atigral::~tc equt
of 12,033 feet as drilled ±n the No. I B'laclljack unit well, :tocated in the 3w~;sw~ c
SectiOn 1, T22N-RI13W, L±neoln County, Wyom:mg; LESS AND E)~CEPT ri hfs assac:l, ated
that produc±ng interval from 10,878 feet to 10,886 feet as establislted for the No.
Blackjact unit well, located ±n the S~¼NE{ .f Sect±tn 12, T22N-Rl13~ , L±nccLn Count
Wyoming.
NOTWITHSTANDING ANYTHING TO THE CONTRARY the intere: t hereit assi§m..d sha~l bear it
proport±onate share of all reservat±ons and cond±t±tns cont;±ned :tn the. instruments
through which the Assignor derived t±tle.
uivalent
with
3
y,
FOR BLM USE ONLY- DO NOT WRITE BELOW THIS LINE
UNITED STATE~ OF AMERICA
This transfer Is approved solely for administrative purposes. Approval does not warrant that either party to this transfer holds legal or
equitable title to this lease.
[] Transfer approved effective
'(^Uthbr~ed'Officer).,.,.. ,
(Tide) .... ' (Dale) .
(Conff.ued on r'eve~e)
'ACKNOWLEDGEMENT (F°ruse by,,CgrPOrati°n)
State oL-----vJ~---g-'lc-!-bl''G''-:~'-'-'-'F ....................... . ........ -I ss, .
TROIqA' - . ....:~ .................... A, D.,,~2.0~3, before me persona Y
County oiL--~--A- ............. :-"- .... ~ -- _ ......... .......................- ~'"~.'e~s6naliy known, who, being by
~ JU~. ................ ' - ·
on ............... - .................................................... --' ............. - ........................................
' ' ~ 0,. 'Wi~'a~ilL-:-:-~-: .......... "~F~=:~:~?'~;?; '~" ..... o{-.~O_.-Q~=~ ........ ~ .... ~]~ i~ ~.Strument Was signed, and
appea~ea i~a?~-l?r7~-:--' . , ,~ ~'~"~ :gY~$~_O~-~-.~:~ .... · ~ -z~"~-0n and that .sa~u~',,, '4' "'_
m~:.~ ..,, ' ' ument m the . said .......................
.2~:~(,.,(~ i~l;;af~.to sa~d tnstr . .... .. ~oard of D~rectors, and
seateu -, .~,.~:.~%....: ' ' .-::. . ~ l~e (tee act anu .. A. ~. ~' '"
Notirf ~1i¢ ~ ...............................
~ ?"~ s' __.8.LZ~OA ................... k .......................... ~ ............ ~--.-:
.... "';';PART B'., GERT'iFICA~ON ~D REQUEST FOR APPROVAL
I, Thc ~f~or ccdifi~ as owner if an lntcr~t in the above d~si~at~d Ieee dml he/she hereby transfers to ~e a~ve assi~c~(s) thc righ~ sp~ific8 a~vc.
2 '~r~&r;r;~=anes~sro~owrf;~T&'~Sr~&e'i's";b z~northcUn cdSmcs'anassocalionofsuchcidzcns'amunicpa y'oraco~ora onBr~anzcaundcr
.." aws of Ihc Unllcd Slates or'o[any Slalg or'tcmlow ihc~o[. For ~c ba~r of NPR-A Ica~s; I~nsfcrcc is a citizen, national, or rcsJdcnl alien of ~c Unil~
..... S a cs or aSsoc at ons of such ci z~ns nat ona s rcsidenl alieos or private public or munic pal corporations (b) T~nsfc~ce s no cons gered a n nor under he
. : ::laws.of Ibc Slalc m which Ibc lands covc~d by Ihl~ l~nsfcr arc I~alcd; (c) Tr~sfcr~c s chargeable inlc~sts, gl[cct and Ind~cc~ m each pubhc domain and
· ., acqui~d lands sep~lcly In ~c sanlc State, ~ not cx~ed 246,080 acres in oil and ~s Ices (of which up to 2~,0~ ac~s m~y~ in oil ~d 2as oplio~), or
3~,0~ ac~s in ;cases in each [ca~bg DistricJ b Alaska ofwMch up to 200,0~ acres may bcb op[io~, ifthb'is'an o[I and ~ lease issued In accor~ncc
with thc Mineral L~asing Act of i 920, or ~ 1,200 acres b any on~ Smtc if this is a ~cothcrmal Ic~sc; (d) All parl[cs holding an Interest in Ibc transfer arc
olhc~isc in compliance with thc ~ulations (43 CFR Oroup 3 I00 or 3200) and thc aufl~orizin2 Acts; (c) Transferee is in compliance wilh rcclamalion
requirements for all Federal oil and gas lease holding! as required by sec. I?(g) oflhc Mioeral L~ing Act; ~d (0 Transferee is n01 in violallon of sec. 41 o[Ih~
Mincat Lc~in~ A~.
3. Trans[crce's signatur~ to lhls assJBmncnl constl~les acceptance o[ all applicable ices, conditions, slipulaiions and restrictions pcdalning lo thc Ic~' dc~dbcd herein.
App cab c Ices and cond tons ncldde bul arc not limited Io an obli~aiion lo conduc al opcrat OhS on thc cascho d n accor~ncc w Ih Ibc Ichns and;condifim so[
the lease, to condition all wells for proper abandon non, to restore thc leased lands upon complcllon o[any opcrallons as described in Ih~ lease, and Io furnish and
maintain such bond a} may bc rcquJrqd by Ibc lessor pursuant to regulations 43 CFR 3104, 3134, or 3206.
·
For 8~thc~al ~sf~rs, ~n ovcniding royalty may not bc less than ~onc-foudh (I/4) ofonc ~r~nl ofthc value of ou~ul, nor ir~ter than 50 percent of Ibc fate of
royalty: ~c to d~c United SMt~ wh~ this ~si~menl is add~ to alt previously created ov~ddin8 royalties (43 CFR 324 I). . '
I certify thai the ~tat¢,nen.ti ma~¢ ~er~:l.n b), ~¢ arc: :true, complete, a.nd correct to the best or,ny knowledge and belier and are made i. good faith·
Executed ihis ' 24t~,: i '..-i¢day o~': June, :~ ~o03 ' Executed this 24 th day or June 20.03
Company
N~m~o[T~ahsferor~sshown0ncmr~nll~s~ ~C0 BELD OIL & MINE~LS C0.
.... 0t G'~--W~l~-fa~-'~'~l~i~t~i~" President G. ~l'lzam~Hur~eMsi~.,t~r~.~ ~esidenc
1738 South Poplar St,
Casper, ~ 82601~
(ci~) (ssi0 (zip ~d~)
Pub c rcport ng burden for this form is cs mated lo average 30 mioules per response including Ihe Ii,nc for reviewing instruclions, gath~:dng and malnlainlng data, and
complcting andrcvicwing [he form. Dircct comments regarding thc burden cstimalc or any other aspect of this form to U,S] Depaamcni of the lntcrior, Bureau of Land
Management (1004-0034), Bureau Clearaocc Olliccr, (WO-630), Mail Stop 401 LS, 1849 C Street, N.W., Washington, D.C. 20240.
Titlc 18 u.s,c. Sec.. 00[makes it a cri~nc for anypcrson knowingly and willfully to make to any Dcpartmcnl or agency o[th~.Unitcd States any false, Iictili0us or fraudulent
atalcmcnts or representations as toany matter within its jurisdiction. ' ':?.';
(Form 3000~3s (1/99) (page 2)