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Home My WebLink About893149T F~,fm ~1~:3 i UNITED STATES (January 1996) DEPARTMENT OF THE INTERiOR BUREAU OF LAND MANAGEMENT 0EPARfHEI~T OF filE INTERIOR BUREAU OF LAN[D HAN.A~EMENI ASSIGNMENT OF RECORD TITLE INTEREST IN A 03 JUL 2 J AH ~'.~1~E FOR OIL AND GAS OR GEOTHERMAL RESOURCES RECEIVED Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.) Act for Acquired Lands of 1947 (30 U.S.C. 351-359) CHEYENNE, WYOMING 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) FORNI APPROVED OMB NO. 1004-0034 Expires: September 30, 1998 Lease Serial No. 'SEE ATTACHED Lease Effective Date (Anniversary Date) SEE ATTACHED New Serial No. SEE ATTACHED Type or Print plainly in ink and sign in ink. PART A: Stone Energy Corporation 1801 Broadway, Suite 700 Denver, CO 80202 ASSIGNMENT Assignee* Street City, State, ZIP Code *If more than one assignee check here r---'] and list the name(s) and address(es) of all additional assignees on the reverse of this fom~ or on a separate attached sheet of paper. This record title assignment is for: (Check one) IXI Oil and Gas Lease, or Interest conveyed: (Chebk one or both, as appropriate) ~ Record Title, --'-]Geothermal Lease ~ Overriding Royaliy, 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, if needed. Do not submit documents or agreements other than 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 MSS Transfer - See Exhibit "A" attached hereto. 533 135 [ RESERVOIR PROSPECT/.LINCOLN CO., WY BOOK PR PAGE .. RECEIVED LNOOLN ;OUNTY (,LERK 8931 t 9 o3s[P-, 33. FOR BLM USE ONLY - DO NOT WRITE BELOW THIS LINE UNITED STATES OF AIvlERICA , FOR ASSIGNEF~ 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; *ssignment approved effective AUG.0 1 2003 By Carmen E. Lovett [~Assignment approved for attached land description ---]Assignment approved for land description indicated on reverse . of this forn~. ,.~ ., ..: [AND LAW EXAMINER AUG g: 1 2003 (Authorized Officer) (Title) (Date) Part A (continued): ADDITIONAL SPACE for Names mad addresses of additional assignees in Item No. 1, if needed, or for Land Description in Item No. 2, if needed. STATE OF COLORADO COUNTY OF DENVER ) ) On this 3rd day of July, 2003, before me the undersigned, personally app~eared Michael E. Cuba, known to me to be person whose name is subscribed to the foregoing instrument as Denver District Land Manager of Stone Energy, L.L.C., a limited liability company and acknowledged that he executed the same for the purposes and consideration therein and in the capacity therein stated. My Commission Expires: Notary Public PART B: CERTIFICATION AND REQUEST FOR APPROVAL 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. 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 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 assoctatton of such ctttzens, nattonals, restdent ahens or,prtvate, .pubhc or mumctpal corporations, (b) Asstgnee ts not constricted a minor under the laws of the State !n which the lands covered by this assignment ad:'lbCat~:d; (c) Assignee%'ch~rgeable interests, direct and indirect, in each poblic domain and acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases (of which 200,000 acres may be in oil and gas options), or 300,000 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 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; aud (0 Assignee is not in violation of sec. 41 of the Mineral Leasing Act. 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 (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 assigmnent 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. Executed this dayof July ,t-9 2003, Executed this dayof July 2003 Name of Assignor as shown on current lease STONE ENERGY, L.L.C. Assignor ~iignature) tr O~ Michael E. Cuba, Denver District Land Manager Attcrn. ey in fact 1800 Broadway, Suite 700 (Assignor's Address) . Denver ' 80202 Assignee Attorney in fact STONE ~Jl.G~ CORPORATION ~. J. Louviere, Vice President - Land (City) ~. (State) (Zip Code) Public reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instTuctions, gathering and maintaining data, and completing and reviewing the form. Direct comifiefits rcg~irding"th~ burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land Management, Bureau Clearance Officer (DW-110), Denver Federal Cenle(, Building 40, P.O. Box 25047, Denver, CO 80225-0047 and the Office of Management and Budget, Paperwork Reduction Project (1004-0034), Wfishington, D.C. 20503. Title 18:U..S.C. iSe~:.,:l.90J:nl~es it .al.crime for any person knowingly and willfully to make to any Department or agency of the United States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction. *U.S. GPO: 1996-774-004/41005 08:9a I...~9 ~53