HomeMy WebLinkAbout895420Form 3000-3a
(January 1996)
BOOK o'~.~ PR PAGE ,
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUR]~AU OF LAND MANAGEMENT
TRANSFER OF OPERATING RIGHTS (SUBLEASE) IN A
LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES
Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.)
Act for Acquired Lands of 1947 (30 U.S.C. 351-359)
Geothermal Steam Act of 1970 (30 U.S~C. 1001-1025)
Department of the Interior Approprianons Act, Fiscal Year 1981 (42 U.S.C. 6508)
FORM APPROVED
OMB NO. 1004-0034
Expires: September 30, 1998
Lease Serial No.
WYW-131931
Type or print plainly in ink and sign in ink.
PART A: TRANSFER
Transferee [Sublessee)* LARIO OIL & GAS COMPANY
Street 301 SOUTH MARKET STREET R E C FL'_ I VE D
City, State, ZIPCode ~,VICHITA, 'KANSAS67202 LINCOLN COUNTY CLERK
*Ifw~re than one u-ansferee, check here X and list the name(s) and address(es) of all addiaonal transferees on the reverse of this form or on a
separateatlached sheet of paper.
8 9 5 t.} 2 0 03 , 0v 2n t0:
This lzan~fer is fun (Check one} X Oil and Gas Lease. or C~othermal Lease
Interest conveyed: (Check o,¢ or boa,. c~ appropriate)(X) Operating Rights (sublm~¢), ( ) Ovemding Royalty, payment Out oFo?~' u~t~on'~.~r,.o, th~_¢,l E R
sirmlar mteresuorpaymerlts~- ~-, ~-.' ,~, %,, ,"
2. This transfer (sublease) conve~ the following interest:
Land Description Percent of Interest Pement of
Additional space on reverse, if needed. Do not submit documents or agreements other tha~' Owned Conveyed Retained Ovemdmg 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 2! NORTH - RANGE 11,3 WEST, 6TM P.M.
Section 2:NW/4 18.75% 3.75% 15.00% None 7.5%*
Containing 160.00 acres, more or less
Lincoln County, Wyoming
Limited from the surface of the earth to the stratigraphic equivalent of 12,315' as found in the
#10-2 Ballerina well, located in the NE/4NW/4 of Section 2, T21N-R113W, Lincoln County,
Wyoming.
This Axsignmem is made subject to that certain Letter Agreement dated October 30, 1997, by
and between Petral Exploration LLC and Lario Oil & Gas Campany covering the above lands
AOL, and is made effecuve Octo~r 2.2000, the day after payot~t of the Eall,~-ina #10-2 well.
*By this assignment, 1% of the previously reserved overriding royalty, proportionately
reduced, reserved by Lario Oil & Gas Company is extinguished.
FOR BLM USE ONLY- DO NOT WRITE BELOW THIS LINE
UNITED STATES OF AMEKICA
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
G Transfer approved effective
By
(Authorized Officer) (Tide) (Date)
Part A (Continued): ADDH'IONAL SPACE for Names and addresses of additional transferees in Item No. I. if needed, or for Land Description In Item No. 2, If needed.
STATE OF COLORADO)
. )Ss.
'COUNTY OF DENVER )O 5 3:54,;40 1 30
On this '3(z~ day of'/~]ow~tAig~.~ ,2003, personally appeared before me, J. B. Neese, who being by me duly sworn, did say that he is
the Vice President of Questar Exploration and Production Company, a Texas corporation, and that said instrument was executed in behalf
of said corporation, by authority of a resolution of its Board of Directors and said J. B: Neese acknowledged to me th'at-said corporation
executed this same. ~-4:~ ~
Notary Public
My commission expires:
qf ,lo
1. The Transferor certifies as owner of an interest in the above designated lease thai he/she hereby u'ansfers to the above transferee(s) the rights specified above.
2. Transferee certifies as follows: (a) Transferee is a citizen of the United States; an association of such citizens: a municipality:, or a corporation organized under the laws ofthe United
States or of any State or territory thereof. For the mansfer of NPR-A leases, transferee is a citizen, national, or resident alien oftbe United States or association of such citizens,
nationals, resident aliens or private, public or municipal corporations; (b) Transferee is not considered a minor under the laws of the State in which the lands covered by this transfer are
located; (c) Transferee's chargeable interest, 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
(ofwhich up to 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 ifthis is a geothermal lease; (d) All parties holding an interest in the transfer
are otherwise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizing Ac~; (e) Transferee 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 Transferee Ls not in violation of sec. 41 o£the Mineral Leasing Act.
3. Transferee's signature to this assignment constitutes acceptance to alt applicable terms, conditions, stipulations and resections pertaining to the lease described herein. Al~licable terms
and conditions include, but are not limited to, and obligation to conduct all operations on the leasehold in accordance with the terms and conditions of the lease, to cundJfion all wells for
proper abandonment, to restore the leased lands upon completion of any operations as described in the lease, and to furnish and maintain such bond as may be required by the lessor
pursuant to regulations 43 CFR 3104. 3134, or 3206.
For geothermal transfers, an overriding royalty may not be less than one-fourth (I/4) o forte percent o£the value ofourpuk nor greater than 50 percent of the rate of royalty due to the United
States wh~ this transfer is added to all prex4ously created ovemding 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 3~ day of November , 2003
Effective, however, as of 7:00 AM. October 2, 2000
~. ExP,~o~'to~ Am ,.OD,~,ON COMPanY
~ ~ N~ ~C~PRESIDENT
F~xecutedthis . 14th dayof November 2003
LARIO OIL & GAS COMPANY
or Michael V'. 0 ~ ~augnnessy
President
(Signature)
(Trans feror'sAddress)
1050-17th Street, Suite 500
(City) (Sme) (Zip Code)
Denver CO 80265
BURDEN HOURS STATEMENT
mntmmn data and
Public reporfng burden for this form is estimated to average 30 minutes per response, including the time for reviewing insu-ucfions, gathering and m ' ' ' g
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Deparm~ent of the Interior, Bureau of l.~nd
Mafiagement, (Alternate) Bureau Clearance.Officer, (WO-771), 18 and C Streets, N.W., Washington, D.C. 20240, and the Office o£Management and BudgeL Paperwork
Reduction 'Project (10(M-0034), Washington, D.C. 20503.
Title I 8 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
statements or representations as to any ma~ter within its jurisdiction.
131
ACIG'qOWLEDGEMENT
STATE OF COLORADO }
} SS.
COUNTY OF DENVER }
The foregoing instrument was ackmowledged before me this 14th day of
November, 2003, by Michael W. O'Shaughnessy, as President of Lario Oil & Gas
Company, a Delaware corporation, on behalf of said corporation.
Witness my hand and official seal.
My commission expires August 2, 2006.
NOTARY PUBLIC
STATE OF COLOEADO
My Commission Explre~ 8/2/2006
Duane L. Haley
8055 E. Tufts Avenue
Suite 1200
Denver, Colorado 80237