HomeMy WebLinkAbout895052Fom~ '3000-3 UNITED STATES
(January 1996) DEPARTMENT OF THE INTERIOR
DEPARTHE,NT OF IHE INTERIOR BUREAU OF I~k. ND MAd',IAGEMENT
BUREAU OF L kND HAt4AGEHENI
~ 0~ ASSIGNMENT OF RECORD TITLE INTEREST IN A
03J~UG2? ~ 9: !~.EASE FOR OILAND GAS OR GEOTHERMAL RESOURCES
RLL;E,VED Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.)
CttEYEI4HE. WYOMING Act for Acqub'cd 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)
Type or prln! plainly In Ink and slain In Ink. · - '
FORM APPROVED
OMB NO. 1004-0034
Expires: September 30. 1998
Lease Serial No.
WYW-155830
Lease Effective Date
(Anniversary Date)
June ], 2003
New Serial No.
PART A: ASSIGNMENT LINCOLN COUNTY CLERK
Assignee* Shawn P. Hannifin
Street P,0. Box 8687
ci~, S,ate. ztP Code D e n v e r, C 0 8 0 2 01 - 8 6 8 78 9 5 0 5 2 0,3 ;OV - r, I0:,31
*If more ~an one ~sign~, ch~k here D and list ~e name(s) and address(es) of ~l additional ~signecs on fl,e~~, ,, 'c~ . '~.',..:..~
~p~ate a~ch~ sheet of pa~r. ~:w ,__
~fi~ r~ord fide ~sig~mnt is for: (Chect one) ~ O~ ~d Gas ~e, or ~ 6eo~en~l ~e
~terest conveyS: (C~ect one or bo,fi, e~ appropriate) ~R~ord Title. ~ Ovc~iding Royal~, paymem out o¢ pr~uction or o~er si~
inleres~ or payments
2. This assil~nmcnt conveys the followin$ interest:
Land De[cription Percent of.i~nterest Percent of
Additional space on rcver~¢,, if ncaa!cd. Do nol s,u. bn.d! documenlz, or agreements other Ihan Owned Conveyed Rclained Overriding Royalty
' · · · ,'- '.. · .. ' · .' . '' 'or Similar Interests
this form; such documents m- agre,~ments shall o~l~ b~'~fer~nced herein.
, Rcserved Previously
· ' '~ ~'i '' .; · ', , ,', ..,;: ;.' .......... ' ... ', '.'.~.; .... , -. , .,; '',,. ,:-..' . , !~. ': ' .;;!rc.~ervr..d;
. f.,'~ t.',.' ;.',' '-.i-'. :, .. '-orconveycd
a .......... . .. , - ,.. , .b .. ~:., d c f
Township 23 North, Range 112 West, 6th P.M 100% 100% None 5.0% None
of
Section 9: SE 8/Sths
Section 10: SW, W/2SE
Lincoln CountY, Wyoming
containing 400 acres, more or less
Subject to the attached rider which includ~ s
a reassignment rider.
FOR nLM USE ONLY--DO NOT WRITE BELOW THIS LINE .... . .................
u.rr.. Sr^'r~ o. A,,t~mc^ FOR ASSIGNEE
i n.s.slgnmenl is approved solely, for achninislrative purposes. Approval doe~ not win'rani thai eilher party Io Ibis assignment holds legal or
table title to this le~se.
sstgnment approvecl for above described landsi..: :% [] Assignment approved for aHached land description
Assignment approved effective SEP^u'~1 2003] [] Assign,nc,,, approved for land description indicated on reverse
of this form.
, on E.'Lovett :~IMn
LAW EXAMIr E'R SE:
Part A (Continued): ADDITIONAL SPACE for Names ,'md addresses of additional assignees in Item No. I, if needed, or for Land Description in Rem No. 2, if
needed, i
The overriding royal .ty reserved hereunder shall be calculated and paid on at least as favorable a basis as royalty paid to the United States on
deral oil and gas leases, and.~ g0~ .e,¥en,t s,h.a!!.,.tl,~e,r.e b,e.,a.ny., deduction for rely expense incurred in making the oil, gas and other prOducts
arketable or ready for use, including, ~out iiot linfiied io ~le~atering, carbbn dioxide fen;oval, deh~,drati0n, separating, storing, c°mpression,
athering and transpmtation costs. ., ..... . .... ' '. . i ' ' ' "'~ ': : fX~
REASSIGNMENT RIDER : ;.'~,:~. , ~:
In the event Assignee desires to relinquish the herein described lease as to all or any_part of the acreage covered thereby, Assignee shall
notify Assignor sixty (60) days prior to lhe next 'accruing rental date under said oil and gas lease of Assignee's desire to relinquish said oil.
and gas lease. Assignor shall then have the right for a period of fifteen (15) days after the receipt of such notification in which to request to
Assignee that said oil and gas lease be reassigned to Assignor, and Assignee shall then execute an assignment of said oil and gas lease to
Assignor. However, Assignee shall not be liable, in damages or otherwise, for failure to give such notice due to clerical error, mistake or
· oversight except liability not to exceed the amount that was paid for this Assignment. Clerical error' shall include, but not be limited to,
reinstatement of a federal oil and gas lease pursuant to lhe Code of Federal Regulations, Title 43, Subsection 3108.2-2. Any reassigmnent
under the terms of this paragraph Shall be free and clear of all burdens, encumbrances, or outstanding interests otl~er than those existing on tl~e
date hereof and Assignee or Assignee's assigns agree not to create any reassignment obligations on tim herein described lease superior to this
reassigmnent obligationl
PART B: CERTIFICATION AND REQUEST FOR APPROVAL
I. The Assignor certifies as owner .~f a's intcresl in the above designaled lease Ihal hc/shc hereby assigns to Ihe above assignee(s) Iht dghls specified above.
such eillzens; a municipality; or a corporation organized under Ihe
STATE OF COLORADO )
COUNTY OF DENVER ) . a ~
on the 29th day of July,2003, personally appeared before me Joe Freeman; Partner, Freem n I instrument,
who duly acknowledged to me that he executed the same.
My Commission Expires: ,~ty~' ~'~/__~L/ ~~
March 9, 2005 N.15~.ry Pubh~;~.~etxO~t~'
I certfy that Ihe statements made herein by me are tree, complete, and correct Io the besl of my knowledge and belief and are made in good faith.
Executed Ihis 2 9 t h day of d u ] y , 19 2 0 0 3 Executed this ,~/~ day of / ,
Name of Assignora~}Uhowa/'o~current lease Freeman I_n_ve_s_tments
~a/'t/le/v' (Signature, Sha-wn -~2 ~~__re)Hannifin
or or
Attorney-in- r, ar.X'. Altomey-in-fact
(Signature) (Signature)
3415 S. ClayLon Blvd.
· (Assignor's Address)
Englewood, Colorado 80113-7611
(City) (Share) (Zio Code)
Public reporting burden for this form is eslimated lo average 30 minutes per response including the time for reviewing insl]'uctions, gathering and maintaining data, and
completing andrcviewing the &mn. Direct comments regardin~ the burden es~mam or any other aspect of this form Io U.S. Department of the Interior, Bureau of Land
Management, Bureau Clearance Officer ~DW-I IO), Denver Fe;leral Center. Building 40, P.O. Box 2504"/, Denver, CO 80225~0D47 and the Office of Management and
Budget Paperwork Reduction Project ¢100:1-0034), Washington, D.C. 20503.
Title 18 U.S.C. Sec. tOOl makes it a crime for any person knowingly and willfully to make Io any Dcpanmcnl or agency of thc Untied Slalcs any false, ficlitious or fraudulent
statements or rcpr~ .,.,~,;,~r,- as lo any matter within its jurisdiction.