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Home My WebLink About9070003000:3 OEPARI'HE,~T OF ~HE ~NTERIOR UNITED STATES DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT ,1," 0583 ASSIGNMENT OF RECORD TITLE INTEREST IN A FORM APPROVED OMB NO. 1004-0034 Expir~: S¢lxcrn~r 30, 1998 L~a~ ~ No. WYW-1 55831 (,M~ivcr~J7 June 1 , 2003 New ~ri~l No. 00LEASE FOR OIL AND GAS OR GEOTHERMAL RESOURCES Mi~ral I.~mi~g Act of 1920 (30 U.$.C. 181 ~ ~xt.) ,~- CH~YE~NE, ¥1YOHING ~~ ~m A~ or ~0 (~ u.s.c. ~m of ~c !~e-~r Approp~om A~. F~ Y~ 1981 (42 U.S.C. ~) Type or pflnt plainly in. Ink and sl~n In Ink. .., PART A: ASSIGNMENT Westport Oil & Gas Company, L.P. - 75% ~670 Broadway, Suite 2800 Denver, Colorado 80202 Th. ia a.~l~am~al conveys flu: following in/crc,st: Land l~ription Percent of lntcrcal Perccm of ~ ~ ~w~, d ~. ~ ~ ~b~ d~u~aU or ag~n~ m~r ~ ~ Couv~y~ Rcm~ Ovemding Roy~ . a b c d · 7OwnShtp 23 NorLh~ Range ~2 NesL~ 6~h P~ ~0.0~ ~00~ -0- 2.5~ 5.0~ o~ ~ecL~on ~0: NE/4, NE/4NN/4 ~tnco~n County, Nyom~n9 :onLatntn9 200.00 acres more or ~ess. REGEIVED 3/~/2005 at ~0:50 AM RECEIVING ~ 907000 BOOK: 580 PAGE: 563 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, ~ FOR BLM USE ONLY--DO NOT WRITE BELOW THIS LINE UI'x~T~) STATP~ OF AMI3~CA s assigamea! is approved g)lely for adrnlnh~ratlve purpo~. Approval do~ not warrant th. at either party to this aasLgameat bo~ legafl or Axaigamcm approved for ~bovc dc~critx>d approved cff~cdv¢ 0 CAR EN LOVETT (^udxx~z~d [] Asaignm~nt approved for attachad land description [] ~g~m ~prov~ for 1~ clean.on ~cat~ on revc~ of ~ fo~. LAND LAW E MINER NOV 1 7 2003 (Tid~) (D~.~) 3:90 Pan A (Cnnl}nucd}: ADDFI'IONAL SPACE for Names and addr~nses of additional ~ssignees in llem No. 1, if m~cled, ~r for ~ De~:rip¢lo~ in Item No. 2, il' MW OIL INVESTMENT COMPANY, INC. P.O. BOX 8687 Denver, Colorado 80201-8687 - 25% PART B: CERTIFICATION AND REQUEST FOR APPROVAL The Assignor cerhfie.~ as owner of an inleresl In the Ihove designated lease thai he/she hereby a~slgaa to thc above assignee(s) Ihe rlghls specified above. As~,igncc ct rlifi~ s ,s follou,'*: (,~) A.,,.,ti~nee Is a ciHzcn of Ihe Untied Slales; an ~oclalloa of Iech cilizens; , manicipallly; or a corporallol organized aad~t I~ of ~hc tlni~cdN~a~es or of any S~le orlerrilory ~hcrcof. For ~he a~*ignmcnlofNPR-A le~,a~lgncc J~a clllzca,,alio~al, or resident alisa of Ibc Ualled Nlalvs t,r aRsoci~lion of salch ciHzc,~, nation,Ix, ~eRidenl alien* or private, public or m,nlclpal cor~ratlon~, (b) Assignee is nol considered a minor lader I~'~ of ~hc gt~e In which the land~ cove~cd h)' Ihl~ a~l~nmenl *~e Iocaled; (c) A~lgnec's chargeable latere~ls, di~ecl a.d ladDecl, ia each p~bllc domain ~nd ~cqui~t'd Ia~tl~ separately in Ibc ~ame Slalc, do nol exceed 246,080 acres In oil ~d gas I~ases (of which ap Io 200,000 acres may be la oil lad gas opIIoas), or 3o0.O00 acre~ in Ic~t'~ in each leading Disltlcl I~ Alaska of which ap Io 200,000 acres may be IR oplioa~, If tkJ~ Is an oil and gas tease Ii.ced te accorda.ce Wilh Ibc ~{int'tal l.e~sing Acl of 1920, or 5 J.200 acres J~ any one Slalc if this is a gcolhermal lease; (d) All Oarlles holding a~ inter.si la Ibc assig.me,I are olhe~i~e in compllanccwilh Ibc regulalions[43 CFR Group3J00 o~3200) and Ihe l~lhorizlagAcls: (e) A*sigaee Is I~ compliance wilh tequircmcnls fo~ ~11 Iq'dcral oil and gas lc'nsc holdings a~ ~quired hy ~ec. 17(g) of Ih~ Mineral ~aslag Acl; and (~ ~ignet I~ aol I~ vlolallol of Mineral ~siflg Acl. A**lgnec's signature lo thi~ a..~ignmenl constitutes acceplance of all applicable terms, condlllous, stipulations and restrictions I'~rtalnlng Io the lease de~rrlbed herelu. ;o, geothermal a.,~slgnf;,cni.,,, a n overt;ding roy~,~y m,,y. nol ,,c ,~css than oae.fourlh (1/4) el' cnc-pereent oLr !he valre ol' ttulp ,~ nor.gre,ler than 50 percent of Ihe rile ol ;.,?al() ,l~,c I,, Ibc tlniltd SI.il,.* v,'hca ~hi.'. :~.,.ignm,..nl is added It: all i,l'cviull~,t) ¢lcalt. d ovctliding ~oyalllcs (43 (.'I:R 32J1). I ccr~it} Ihal thc stalcmcnt., m,tlc herein hy me are lruc. complete, and corrct:t to thc best of my knowled~ and belicf -,nd ~r~ m~le in goad faith. Exe. c~ted ~lu , · day oF . . , 1996 'uNk~ rFl~rtir~: bt,fdc~? rot ~hi.~ for, n ~i.~. estimated ~o av~,g~ 30 Tin?tes.~r r?~se includiqg thc I1~ [~. [~wing inm~ns, gst~d~and ~min~ dina, ~d *,mp~ng a~rcv~winF I~ /Ollll. ~;Jrccl c(,itmenl~ r~a~ln~ lac o~acn Csllnlglc ~ any ~r n~ ~ Ibis /~m to U.S. Dep~cnl of I~ Inledor. B~mu of ~nd . an~emcn.~ ttu~au C e~ce OfF~cer (DW-110) ,~mver- F~cml Con er, Bud ng 40 ....... PO Box 25~7 Den~r ~ ~25-~47 and he O~ o[ Mma~t and i'u%'gcl. I'a~'l~t)& Rcducll~ ['~ujccl ( 1[~-(~.141. ~ nsh~nglon. D.C. 20503. to : ~::;~ny ~panmenl or agony of~'Unit~ S~tes ~n~ :~m~ or Fraudulent Ulc 18 U S:C. ~c. a crime for uny ~ knowingly a~ willfully ~ .... (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. 0 070 0 PART B: CERTIFICATION AND REQUEST FoR APPROVAL The Assignor certifies as owner of an interest in thc 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 (f) Assignee is not in violation of sec. 41 of the Mineral Leasing Act. Assignee's signature to this assignment constitutes a~eceptance of all applicable terms, conditions, stipulations and restrictions pertaining to the lease described herein. ~r geothermal assignments, an overriding royalty may not be less than one-fourth (¼) of one percent of the value of output, nor greater than 50 percent of the rate of royalty ,e 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 lzh day of Ju 1¥ 2003 Executed this lOth day of September 2003 ame of Assignor as shown on current lease ~signor or ttorney-in-fact _~~n e type or print (S2~at~re) P.O. Box 8687 (Assignor's Address) Denver, Colorado 80201 (City) (State) (Zip Code) Assignee WESTPORT OIL AND GAS COMPANY, L.P. (~ or LAI ttomey.in_fact _.,nature) David R. Dix, Attorney-in-Fact blic reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and mpleting 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 anagement, Bureau Clearance Officer (DW-110), Denver Federal Center, Building 40, P.O. Box 25047, Denver, CO 80225-0047 and the Office of Management and idget, Paperwork Reduction Project (1004-0034), Washington, D.C. 20503. tie 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 ttements or representations as to any matter within its jurisdiction. *U.S. GPO: 1996-774-004/41005 Part A.'(Cnntinucd): ADDITIONAl.' SPACE for Names and addrc.~scs of additional usignces in Item No. 1, if __~ed~___, ir for Land De~crilxim in IMm No. 2, if n~xicd. 0 )07000 PART B: CERTIFICATION AND REQUEST FOR APPROVAL Thc Assignor certtfies ss owner of an Intcrc,-I IA Ihe above dcalgnAIcd lease thai hc/she ku'reby nAslJfla to eke Above asaijucc(s) Ibc rlgkls specified Above. Assignee crrtifit's as follows: Ca) A.,~il~ncc Is s citizen of Ihe United arnica; an ss.$oclatlon ofs~ck cilizcns; a mvnicip~llly; or I corporallo~ or,seized ~dc~ Ibc acquhcd la.d~ scpa~alcly in Ibc ~$me ~lllr, do flol cxc{{d 246.080 acre~ In oil ~nd gas leases (o[ w~lc~ .p Io 200,000 $cre~ may b~ I. oll ~nd ~s~ opllo.s), or 3no.o0o .c~ in leases In each leasing Disulcl In Alaska of whlc~ .p to 200,~00 ,ceca tony be In options, I{ Ibis Ii an oil and gas leIR lin.ed I, a{:cordancc wllh Ihe Mineral ]xasing Act of 1920, or 51.200 acfe~ in any one Slale if Ibis Is I geothermal Pease; Cd) All parties holding ia inlercsl il I~c I;~]g~menl irc oihc~l$c In compliance wilh the regulalions (d3 CFR Group 3100 or 3200) and Ibc I~lhoflzing Arls;'(e) Assignee Is in compliance with recllmalion fcquircmcnl~ ft,f iii l:t'dcral oil and gas Ionic holdings s$ <quircd hy acc. 17(gl of Ibc Mineral ~asln~ Act; and (0 ~signet la not in violal[o= of ~e. 4] of iht Mineral ~asing Acl. As.<lgncc's signature lc, this ss.,,ignmcn{ conSlllulcs acceptancc of All applicable terms, conditions, AIIpuIslIoAA and rcslrlcllou.< pertaining to the lease de~rlb¢(I hcrelu. ,eeolhcrmsl asslllnmcnls, an overriding royally may sol be Ics.s than oac.fourlh (1/4) of one pcrccn! of thc val.e of output, nor grcalcr Ihan $0 percent of Iht ralc ol thc (Inilcd Si.lies when this a~.'-ignmcnl l$ ad,lcd to all i.'cvlou~.l) ctcnlrd ovcrtldin~t roynlt]~ (43 CFR 3L'4 I). I ccd. il}' thai iht slalcmcm,, m.dc hcrrin hy me ar~ tree. complete, and corr~ Io thc best of my knowledge And belief And ar~ mndc in ~ faith. Executed this day of . . Name of Assignor n.< shown on cunxnl le~ts¢ AUorney-in- fncl (Signature) Plca~ typo or pont (Signature) (A~ignur'.< Addr~$) (City) (Sam) ('Zio Code) 2003 %btic rcponin~ b.rOen roe chi< form is estimated Io nvcragc 30 minulcs per response includin. R thc lime for reviewing in~z'ucdonA, gathcrtn~ amd n'~lntalnlng d-~n, ~nd :t,mpletinF and rcvicwi..n,{c thc £m?.~{:. Dtr.cc.~ot, i[~n~.'.'nl.~ rcgaM~inl~ th,e ~burdcn ~;,~lt..ngtc ~..,an.,v~r n~acct o¢' this form to U.S. Dcpamnem of thc Interior, Bureau of Lmnd \~anagcmcnt. Bureau C lear.'.JCC u/ttcer tu -t lU;. ocnvcr r~cral t. cnler, uuttatng ,~u, r.u. uox 23047, Denver. CO R0225-0[)47 and the Offlc~ of Mmag~men! and h~Jgei. I'al~t'~.ork Rcduclion P~ujcut (I{X}4-(}034). Washington. D.C. 20.fi03. itl{: 18 U.S.C. Sec. 1001 make.< il u crime for any per,on knowingly and willfully to n~kc lo any Dcpadmenl or agcnc~ of ISle United Stale~ any fall,e, fictitio~.< or fraudulc,t · ;.crncnl.< or rcp~--.enlutions a'. lO an}' mailer wilhin ils jurisdiclion. .-_..--_ .... ...= : -.-77-~'-7': _--.. .--._-..-_- INDIVIDUAL STATE OF ~'~~ ) CITY & COUNTY OF ) t~ . ,o_. -'Bef°re me, the undersigned, a Notary Public in and for said County and State on this ¢_~t:9 day, of ~~ ,2003, personally appeared Shawn P. Hannifin, to me known to'ir identical p~son (s~who executed the within ~d tbregoing instrument and ac~owledged to me that he executed the same as hi~ flee and voluntary act and deed for the uses and pu¢osed therein set fo~h. Given under my hand and seal of office the day and year last above written. My Commission Expires: Notary Public Address:,,.~,_.~dS9 ,,/7T"~?'- ~t'~.&gd:9