The URL can be used to link to this page

Home My WebLink About875232 Form 3000-3 (October 1992) .- .~:~ I(' ':, UNITED STATES ..... .~' ~t~ ~ ~?..'z~,-. DEPARTMENT OF THE INTERIOR FORM APPROVED · . :.' ,'~' ~" ",~' ,.,~ ,Bt .... BUREAU OF LAND MANAGEMENT OM8 NO. 1004-0034 ~1\ 3~1'~ ~,0~ t,t~'[ r,~ I~[~ ASSIGNMENT OF RECORD TITLE INTEREST IN A Lease Serial No LEASE FOR AND GAS OR GEOTHERMAL RESOURCES ~'~,~ ...... ..,- ul 4 ~Vt/~'t~ Mineral Leasing Act of 1920 (30 U.S.C. 181 et seq.) ~ x( [! ~(,[~{~/.., ~''' ~ Act for Acquired Lands of 1947 (30 U.S.C. 351-359) ~.,t-~':~ ' Geothermal Steam Act of 1970 (30 U.S.C. i001-1025) Lease Effective Date Department of the In[erior ApproPriations Act, Fiscal Year 1981 (42 U.S.C. 6508) 4/I/01 T eor rint lalnl In Ink and si nlnink. · PART A: ASSIGNMENT , · Street 1645 Court Place, Suite 422 '- City, State, ZIP Code Denver, CO 80202 · If more than one transferee, check here [ ] and list the name(s) and address(e~) o~ all additional transferees on the rever~ lbflhia4'or, m_or on a separate attached sheet of paper, ' This transfer is for: (Check one) [X ] Oil and Gas Lease, or [ ] Geothermal Lease ' similar interests or payments 2. This assi~ent conve_7_~ the following interest: Lana L~escnption Percent of Interest . Percent of ' . Overriding Royalty Additional space on reverse, if needed. Do not shbmit documenls or agreements other than this Owned Conveyed Retained Or Similar interests form; such documents or agreements shall only be referenced herein. Reserved Previously reserved or conveyed A b ¢ d e f 7own_.ship 22 NortJl, Range ! !~ West, 6~h P.M, 100% 100% Section 25: SW 0.5000% 0% Lincoln County, Wyoming 160.00 acres more or less llrCm m ~.r [my nx:t v hr, ~.~na- WRITE BELOW THIS LINE THE UNITED STATES OF AMERICA This assignment is approved solely for administrative purposes. Approval does not warrant that either party to this assignment bolds legal or equitable title to this lease. [ ] Assignment approved for above described lands; [ ] Assigmnent approved for attached land description Assig,ment approved effective [ ] Assignment approved for land description Indicated on reverse of this form By (Authorized Officer) (Title) (Date) Part A (Continued): ADDITIONAL SPACE for Names and address'es of additional assignees in Item No, 1, if needed, or for Land Description in item No. 2 if needed t.~ ..,} ,~ .- 538 ~CKNOWLEDGME~T STATE OF COLORADO ',' COUN'rY OF DENVER The foregoing instrument was acknowledged before me this 20th day of April, 2001, by NiOonX~. Lange, Manager of Condor Exploration LLC, My Cmnmission Expires: PART B: CERTIFICATION AND REQUEST FOR APPROVAL 1, The Assignor ce~ifies as o~mr of an interest in the above-designated lease that h~she hereby assigns to the a~ve assignee(s) the rights specified above. 2. Assi~ee ce~ifies as Follows: (a) Assignee is a citizen of the United States; an ~qsociation of such citizens; a municipally; or a co~0ration organized under the laws of the United States or of any State or tcrrito~ thereo~ For the assignment of NPR-A leases, assignee is a c tizen, national or resident alien of the Unit~ States or associations of such citizens, nat onals, 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 assign ne ~t are located; (c) Assignee's chargeab e nterests, 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 (of which up to 200,000 acres may be in oil and gas options), or 300,~0 acres in leases in each leasing Dis~ict in Alaska 6f w ~ ch up t~ 200,000 acros 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 S'tate if this is a geothermal lease; (d) All panics holding an interest m the assigmneut 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 ail Federal oil and gas lease holdings as required by sec, 17 {g) of the Mineral leasing Act: and (0 Assign~ is not in violation of sec. 41 of the Mineral Leasing Act. 3. Assignee's signature to this assignment constitutes acceptance of all applioable terms conditions stipulations and restrictions pertaining to the Ieee 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 Uoited States when this assignment 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 b~st of my knowledge and belief and are made in good faith. ~ day of 2001' Executed this day of 2001 Executed this Name of Assignor as shown ou..m~rrent lease ,..--.-C. ondor E~b~>ration, LLC Assignee: (Signature) 7720 E, Belleview ~venue ~ (Asslgnor's Address) z Assignee: En~;lewood, CO 80111 (City) (Stste) (Zip Code) , Attorney-in-fact (Signalur~) Pul)lie reporting burden for this form is estimated to average 30 minutes per response including the lime for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or an)' other aspect of this form to U .S. Department of the Interior, Bureau of Land Management, (Alternate) Bureau Clearance Officer (WO-771), 1849 C Street, N.W., Washington, D.C. 20240, and the Office of I',tanagement and Budget, Paperwork Reduction Project (1004-0034), Washington, D.C. 20503 Title 18 U.S.C Sec. 1001 makes it a crime for any person knowingly a}:d willfully to make to an), Department or agency of the United States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction. ' '