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Home My WebLink About906999Form 3000-3 s'rA 0558 DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT FORM APPROVED OMB NO. 1004-0034 F. xpir~: $¢]x~rll:~r 30, 03 ~.~? ~-~ [~'~ o~: [:)~EASE FOR OIL ~D GAS OR ~EOTHERMAL R~URCES ...... t~ M~ ~gAct of 1~0 (~ U.S.C. l~l ~ ~.) ~{~' ~m of ~ ~r Appwp~o~ Aa, F~ Y~ 1981 (42 U.S.C. ~) Type or print plainly I.n Ink and s,i~n In Ink. Lo~ Scri~ No. WYW-155830 ~ Effomiv¢ D~ (A,~',ivcrury I:~) June 1 , 2003 Ncw ~ No. PART A: ASSIGNMENT A.uig~e* Westport Oil & Gas Company, ~ 1670 Broadway, Suite 2800 C~,~,Z~C~ Denver, Colorado 80202 n.P. - 75% 2. Th~ ~iaisnm~m convc~,s th~ foUowLng inu:re~t: l..snd De~rijxion Pcrccm of Intcrcs! Pcrccnt of AckLitio,~l spac~ on r~vcr~, ii' n,~-M. Do not ~ubn~l docum~nt~ or agroomcnts other than Ow~x:l Convcyod Renamed Ovcmding Royally or $ Lm.~r form; ~ d~cum~ or .~__-~-~s ~ mdy b~ referenced ~ia. ., · . b c d c f ?ownship 23 North~ Range 112 West~ 6th PN 100% 100% '02 2.5% 5.0% of Section 9: SE/4 of 8/8tbs Section 10: SW/4, W1/2 SE/4 8/Sths L±ncoln Count_y, Wyom±n9 containin9 400.00 acres more or less. ~ RECEIVED 3/11/2005 at 10:4g AM REGEIVING # 906999 BOOK: 580 PAGE: 558 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY FOR BLM USE ONLY--DO NOT WRITE BELOW THIS LINE UNITI[O STATES OF A.MRR,ICA This...a'~igmnent is approved ~olely for adm!~t~xative purpo~l. Approval doe~ mA warrant that either party to this a.~ignment honda legal m' equj/.at~ title to tl~ I~sse. ' ' ~ [5J As~igam~m approved for ~ovc cie~crib~ lan't_,,; [] A~igamcnt approved for attached la. mt description Agligangnt approved cff~cdvc OO T 0 CARi EN LOVETT _?003 (Au~.~xl Officer) [] Ar~ignmem gopmvocl for hind dcscripdon h~clica~l o~ rcvcrsc of ~ form. LAND LAW EXAMINER NOV 1 7 2003 (Ti~) Part A (Continu'~l): ADDITIONAL SPACE for Names and sddr~.~ses of addition,,l assignees in llem No. 1, if needed, 6r for Lu~d Descril~ion in l!~m No, 2, if MW OIL INVESTMENT COMPANY', INC. P.O. BOX 8687 Denver, Colorado 80201-8687 - 25% PART B: CERTIFICATION AND REQUEST FOR APPROVAL I. Thc Assignor ccrhfic.', as owner nf an Inleresl In Ihe shove designated lease Ihal he/she hereby ssslgns In Iht l~vc assignee(s) Iht rights s~clflcd above. A~slgncc c~ rlifh s ~s follows: tn) A~signcc Is a cilizcn of Ibc Untied Slilcs; In i~ocllllon of sicb cilizcns; a munlcipallly; or a corporalloi oral.lied .Idcr Ihe I~ ~,f ~hc ti. ileal S~lc~ or of nny Slnlc or Icrrilory Ihcrcof. For ~hc assignmc. I of NPR-A len~s, a~l~.ce Is a chlzc., n~lional, o~ rcsldenl alien of Ibc Unhcd Slnl,..~ t,r ~s.ci~fion of s.ch cilizcns, n~lionsl~, ~c~ldcnl alien~ or private, public or municipal cor~raHons, (b) Assignee Is nol on.sidereal . minor iIdcr I~ oI ~hc' Slnlc In which Ibc Innds covc~cd h)' Ihlss~lgnme~la~c Ioc~lcd; (c) As~lsnec's chargeable Inler.~ls. dirccl nnd Indirccl, In ~ack p~bllc domiln ~nd ~cNuhcd I~.d~ ~cps~lrly in Ibc s~mc Slnlc, do flol exceed 2,16.080 acres I~ oll nnd gas leasco (of which .p Io 200,000 acres may be I. oll and ~as opllo.s), or ~n~ nO ~crc~ in It4~cs in cnch tc,~slng Di~lHcl In Alaska ~f which .p Io 200,000 acres tony be I~ opllo.s, If Ihts Is ~. oll a.d gas lease Issied I~ accorda.ce whh Ibc htinrr~l I.cssing A['l o[ 1920, or 51,200 ~crcs In ~,y one Slllc if Ibis Is a gcolherm~l Ic~sc; (d) All p~rllcs holding ~, inlelesl I~ Ibc ~ssig.mc.I olhc~'isc in cumplilncc wilh ~he regul~Hons {4J CFR Group 3100 or 3200) lnd Ibc a.lhorizing Acls; (e) Assignee Is In compliance wilh rccl~mlllon scquircmcnls f~,~ ~ll Fcdcr~l oil nnd g~s Iclsc holdings ns required by sec. 17(g} of thc Mineral ~si.8 Acl; and (O A.~signcc I~ not In viol~llo, of sec, 41 ~incr~l ~asing Acl. ). A~lgncc's sign~lurc ILl Ihls isslgnmcnl conslllulcs iccepllacc of ~11 ippIlciblc lerms, condlllols, sllpulailo.s ind rcslrlcllo.s pcrl~lnln~ Io Ibc le~sc I',,r peolhcrmal issignmenI~, an overriding loyally may not bc less Ihzn onc.[o.-O, (I/4) of one percent of Ihe value o[ o~lr.(, nor 8rczlcr Ihan 50 ~rccnl of thc tale nj i ccrli~ thai thc statcmcnt~, merle herein by mc arc true. comolclc, and corrccl to thc b~st of my knowled~ and belief and am made in good faith. W,me of Assignor ns shown on curr~n( lease Shawn P, Hannifin ~,ttorn,~-in- rm~ 730 ]Tth Street, Suite 625 (Assignor'~ Add~s~) D'enver, Colorado 80202 (City) (St~t~) (ZIp C~c) Executed d~la day of . 19 9 6 AHomev-Jn-tact (Sl~rnamm) ;,bile reporting burden rot fhi~ Form is exlimnled In avenge 30 min,Jles per re. sponge includin, g Ihe me tot rev ew ng in,~tructton~ gnlhednff and malnta n ng dina, and ,cnpl¢~in~' ,mdrcxk:wi.~: Ibc I'ullll. Dirccl c(..mcnl~ regarding Ibc burden ¢.qUlmle ~ an)' nlbcr a~pcc o! h s f~m 1o U.S. De artmcnt of IFc Inlerior Bureau o l:m.'~cmdn~ [lurcu'.~ t'h';u:.,cc Olficer (DW-I I0). Denver Federa Center, Building 40 P.O. Box ~5047 Denver CO ,~O'22.5-~'~347 and he Office of ~na mcfnLand ;lc 18 U,S ('. SL'C IOtql makc~ .il a trinse for any ....... person knowingly and ¥.ilJrully io make to any Depnrlmenl of :igency of the Untied States an), false, 6ctilious or [raudulc.t rt A (.Continued): ADDITIONAL SPACE for Names and addresses of additional assignees in Item No. 1, if needed, or for Land Description in Item No. 2, if needed. 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 of 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 association of such citizens, nationals, 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 assignment are located; (c) Assignee's chargeable interests, 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 300,000 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; and (t') 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. · geothermal assignments, an overriding royalty may not be less than one-fourth (~A) of one percent of the value of output, nor greater than 50 percent of the rate of royalty : to the United States when this assignment is added to all previously created overriding royalties (43 CFR 3241). ertify 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. ecuted this 3 0 L h day of 0'1-11 y 2003 me of Assignor as shown on current lease Sha~vn P. ~Jannifin . ~PI e or print slgnOror ' ' (SigUartu(-~ :orney-in-fact (Signa~e) P.O. Box 8687 (Assisnor's Address) Denver, Colorado 80201 (City) (State) (Zip Code) Executed this lOth day of September 2003 Assignee WESTPORT OIL AND GAS COMPANY, L.P. Attorney-in-fact (Sig~ David R. Dix, Attorney-in-Fact )lic reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and npleting and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land nagement, Bureau Clearance Officer (DW-110), Denver Federal Center, Building 40, P.O. Box 25047, Denver, CO 80225-0047 and the Office of Management and :lget, Paperwork Reduction Project (1004-0034), Washington, D.C. 20503. ie 18 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 ements or representations as to any matter within its jurisdiction. *U.S. GPO: 1fl96-774-004/41005 Pan A (Cnntinud);_ ADDITIONAL SPACE for Names and addr~,~scs of additional assignees in Item No. 1, if needed, ir fro' Land De~crtlxtO~ in l~,'m No. 2, it' ~PART~-tr?~ r Of 03 SEP 29 /if / 9:O0 PART B: CERTIFICATION AND REQUEST FOR APPROVAL i. 'rhc Assignor cett~fics as owner or an Inlercal in the Above designated lease thAI hc/,he hereby a,lgnA to Ibc above aaAlguc¢(a) Ibc rlghl, s specified Above. 2. A~,.'.i~ncc ct rlifirs ns follows: (~) As...i[~ncc ii a citlzca o1' thc Untied Slates; in association of such citi?.cna; a mnntcipllly; or a corporation organized under Ibc laws d' Ibc [Inilt'd Stales or r,[ any Stale of Icrrilory thcrco[. For Iht Asaignment of NPR-A llamA, A~lgucc is a chlzcu, national, or rcsldcul align o[ thc United .~I,llcS '.,f JSsocislio. Of SUCh cilia'ns, nalional!,, Ica. ideal aliens or privale, public or municipal corporallonL (b) Assignee Is sol conaidcred a minor alder thc laws d' Ibc Slain In which thc land.~, covc~cd hy Ibis a~.~lgnmcnl arc Iocaled; (c) Asslgnec's charFsblc JulereslL dir¢cl and Jadirccl, la each public domain and acqullrd lands ...Cl~:,talcly in thc .mc Slslc, do sol exceed 246,080 Acres in oll and gas lc.es (of which ap to 200,000 acres may be la oll sad Sas options), or 300,000 acrc.~ in Ir,~st'a in each IcAslntl Disd¢l In Alaakn o1' which up lo 200,000 Acrca mu), be la opllonn, If Ibis Is aa oil and gas lea~e Issued in accord.cc wllh thc Mineral I.ca.slng Acl el' 1920, or .';1.200 acres in any one Slain if this Ir, a Fothermal lose; (d) All purlieu holding aa interest IA the assignm. I arc olhcrwiac In compliance wilh Ibc regulalions (4.1 CFR Group 3100 or 3200) .,nd Ibc "lhorlzlng Acts;'(e) A~,siguec is In compII.ce wllh reclamation rcquir,:mcnl.s ft-' all Frdcral *.',il and g.as Icssc holdings as required hy ncc. 17(g) of Ibc MinerAl LeAslq Acl; and (0 A..s.~tgnce is sol in vlolallos of ~c. 41 of she Mineral Losing Acs. .1. A.ss~gncc's slgnslurc Itl Ibis as.,,ignmcnl conslllules acceplancc ol' all applicable lerms, condJllois, sllpulnllons And rcalrlclJons f~:rtaJulul Io Ihe lease de~crlb,t'-d hcrcll. I:,,r FofhcrmAI assignments, an ovcrridinlJ royally may not bc Ic.~ Ihan onc-fourlh (fid) of one percent of Ihe value o1' output, nor greater Ihau 50 pa:Petal of the nil ol ru.~.flt) ,Jl*t t,~ Ibc ttnIIc'tl Slak'~, who,1 shin a~aiknlllt:lll la sd,:cd la. all i,l'cv;uu,sJ) cleated ovcrlid;ng ro.yuJljcs (4.3 C.'I;J~ .t'-'4 J). I ccrlit~ thai thc slotcrncnl~ rustic herein hy mc arc truc. complclc, and coerce1 lo thc beat of my knowledp and beli¢l' and arc made in good faith. Executed thcs , day d' Name of Assignor as shown on cumnl lease Attornq-in- fac~ (Signature) Ple..~ type or print i (Signature) (Aasignur's Addre~) (City) (St,m) {Zle £~,~mi, 30th '~xor Ju~y , 2003 MW OIL INVESTMENT CO., ..-. Frances A..ann~.~% 'ubtic rcl~or~irn.t.__ bt rdcn ror h ~ I'orln is. cdmaled .... lo nv~'nge 30 minnies per respon.~c nclud nC thc lime f~' rcvtewln, g inru'uctlona, gatheri and maintaining data and t,mpleltnl: and-reviewing thc fotrtt. Dtrecl c~a~tmcnls regarding Ibc burden ¢.sll. nt.,q, lc ur any o~hcr aq:,:ct of this f~m to U.S. Depa. rtmen! o~tn~ Interior Bureau of L.~nd ,lan:~gcmcnl. Burcuu C lea',~cc (.)~ccr CDW-110), ~..D~.~ver Federal Center, Butldtng 40, P.O. Box 25047, Denver, CO 8022~CI347 and the Office or ManaFmcnt and h~lgd I':~F, cs~ork Reduction hu.l~cl (I{)04-t~J4). ~,ahinglon. D.C. 20503. illc 18 U.S.C. Sec. ~001 makcs il a crin~: [or un), pcr~o~ knowingly and willfully io make to any Departmenl or Rgency orthe United States any false, fictitious or I'ruudutcnt ;,tcmcnl.~ or rcprc~cnr,lionx ns In an.',' n~llcr wilhin iL~ jurisdiction. INDIVIDUAL STATE OF _(~~ ) ) ss . CITY & COUNTY OF efole m ~e~ r~ me., the undersigned, a Notary Public in and for said County and State on this~-~--~ day, of ~ ,2003, personally appeared Shawn P. Hannifin, to me known to-l~eTidentica! pe~on (s) w(-~o executed the within and foregoing instrument and acknowledged to me that he executed the same as his_ free and voluntary act and deed for the uses and purposed therein set forth. Given under my hand and seal of office the day and year last above written. My Commission Expires: ._~ff,:..~-./,/t~! Notary Public Address: 7.-~d:P