ASSIGNMENT OF INTEREST IN OIL AND GAS LEASE INSTRUCTION - PDF by eel17334

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									                ASSIGNMENT OF INTEREST IN OIL AND GAS LEASE
                            INSTRUCTION SHEET
                     DNR FORM DO&G 25-84 (revised 11/09)


DEFINITIONS:

Assignor: A person transferring an interest in an oil and gas lease.
Assignee: A person receiving an interest in an oil and gas lease.
Working Interest: An interest in an oil and gas lease that gives the owner the right to
      work on leased property as well as the obligation to pay costs.
Overriding Royalty Interest: An interest in oil and gas produced at the surface, free of
      the expense of production, and in addition to the usual landowner’s royalty
      reserved to the lessor in an oil and gas lease. A royalty interest carved out of the
      working interest.

Oil and gas leases may, with the approval of the commissioner, be assigned to any
person qualified to hold a lease. Please see the Qualification FAQ at the following web
link for questions regarding qualification:
http://www.dog.dnr.state.ak.us/oil/programs/leasing/leaseadmin/qual_faqs.html.
Use the following instructions when completing an Application for Assignment of Interest
in Oil and Gas Lease form DO&G 25-84 (revised 11/09) (attached).
Each application must:

1:     Have only one assignor.
2:     Have only one assignee.
3:     Have only one lease.
4:     Be filed in triplicate (one copy will be returned to the assignor, one will be
       returned to the assignee, and one will be retained by the state).
5:     Be accompanied by $150 filing fee for the transfer of working interest or the initial
       separation of overriding royalty interest.
6:     Be filed within 90 days of the final signing of the transfer by the assignor;
       however, an assignment not filed within 90 days may be approved, at the
       discretion of the commissioner, where no intervening interest is filed.

If the application is approved, the effective date of the transfer is the first day of the
month following the date on which the assignment application is filed and the filing fee
paid. Upon prior written request, the effective date of the transfer may be the first day of
the month in which the assignment application is filed with the state. The assignment
requirements can be found under 11 AAC 82.605 – 11 AAC 82.615.




                                                                                           1
PAGE 1 OF APPLICATION              All spaces must be completed.

This form may be used for transferring a working interest or overriding royalty interest.
Leave blank the spaces that do not apply to this application. Ownership must be
expressed in decimals with five or fewer digits to the right of the decimal, unless
previously approved by the state.

Please use the addresses on file with the Division of Oil and Gas. If the addresses on
file with the division are no longer current, please attach a letter requesting a change of
address with your assignment application. Notice of approval or denial of assignment
will be returned to these addresses.

Both parties must be qualified to hold an oil and gas lease pursuant to 11 AAC 82.200 –
11 AAC 82.205. Those acting as a signator on behalf of a corporation must be
authorized to do so by power of attorney or corporate resolution. If the Division of Oil
and Gas does not have a document on file authorizing a signator, please submit a
document to that effect with the assignment application.

COMPLETE ITEMS 1 THROUGH 9. Leave blank those spaces that do not apply.

Item 1:       Insert the ADL number for the lease affected by this transfer.
Item 2:       Insert the assignor’s name.
Item 3:       Insert the assignor’s current address as listed in the assignor’s
              qualification file.
Item 4:       Insert the assignee’s name.
Item 5:       Insert the assignee’s current address as listed in the assignee’s
              qualification file.
Item 6:       Insert the assignor’s current ownership of working interest or overriding
              royalty interest.
Item 7:       Insert the percent of working interest or overriding royalty interest to be
              transferred to the assignee. State the interest to be assigned as a percent
              of total lease interest. For instance, if the assignor owned 50% interest in
              the lease and wished to transfer one-half of his interest, this item would be
              25%.
Item 8:       Insert the percent of working interest or overriding royalty interest to be
              retained by the assignor.
Item 9:       List the lands affected by this assignment of interest by Township, Range
              and Meridian. The sections and aliquot parts description must be inserted
              below the township and range. If the legal description is lengthy, attach
              Exhibit A from the lease and insert “See Exhibit A” in this space.
              Additionally, insert the total numbers of acres affected by this assignment.



                                                                                            2
If the notification lessee has changed due to an assignment of interest, please
designate a notification lessee in the space provided. The notification lessee is an agent
authorized to receive notices on behalf of all lessees from the State of Alaska in
connection with a lease. If the notification lessee has not changed, please leave this
section blank. Please leave this field blank if the assignor or assignee for the
assignment is not the current notification lessee.

PAGE 2 OF APPLICATION

The signature page must contain original signatures of both the assignor and assignee
witnessed by a notary public, the date, printed or typed name and title of the signatories,
and if applicable, the company names and qualification file numbers. Individuals
qualified to hold an oil and gas lease are not assigned qualification numbers, only
corporations.

Please send the completed applications of working interest to:

                            Department of Natural Resources
                               Support Services Division
                               Financial Services Section
                              550 W. 7th Ave, Suite 1410
                              Anchorage, AK 99501-3561

Please send the completed applications of overriding royalty interest to:

                            Department of Natural Resources
                                Division of Oil and Gas
                               550 W. 7th Ave, Suite 800
                              Anchorage, AK 99501-3560

If a filing fee is required, include a check or money order made payable to the
Department of Natural Resources. Should you have further questions regarding
assignment applications please contact Allen Eddy at (907) 375-8259 or
allen.eddy@alaska.gov .




                                                                                         3
APPLICATION FOR ASSIGNMENT OF INTEREST IN OIL AND GAS LEASE                                DNR USE ONLY
STATE OF ALASKA                                                                            Unit: ___________________
DEPARTMENT OF NATURAL RESOURCES
                                                                                           PA: ____________________
DIVISION OF OIL AND GAS
                                                                                           Acct code: ______________

1.   Lease ADL #

2.   Assignor:

3.   Assignor’s address:



4.   Assignee:

5.   Assignee’s address:


6.   Assignor’s current                                percent working interest OR
     ownership:                                        percent overriding royalty interest

7.   Amount to be                                      percent working interest OR
     assigned:                                         percent overriding royalty interest

8.   Assignor is retaining:                            percent working interest OR
                                                       percent overriding royalty interest

9.   LANDS AFFECTED by this assignment of interest (attach Exhibit A if necessary)
     T            ,R          ,         Meridian




     containing                               acres, more or less.

The Notification Lessee for the purpose of receiving any and all notices from the State of Alaska in connection with
the lease will be:
Name
Attn
Address
City, State, Zip                                         Telephone (        )

We, the undersigned, affirm that the information provided on this application is true and correct and that it is filed
pursuant to 11 AAC 82.605 and 11 AAC 82.615. We further affirm that both parties to this agreement are qualified
to transfer or hold an interest in oil and gas leases pursuant to 11 AAC 82.200 and 11 AAC 82.205. Whether
approved in whole or in part, the assignee agrees to be bound by the provisions of said lease.
                                                                                DO&G 25-84 (LEASE ASSIGNMENT) Revised 11/09 DNR #10-113
ASSIGNOR:


Authorized Signature                                           Date


Name & Title (Print or Type)                                   Corporation/Company Name

UNITED STATES OF AMERICA                    )                  DOG Qualification File #
                                            )SS.
STATE OF                                    )

THIS CERTIFIES that on the                      day of ___                       , 20      , before me appeared
                                                       , known to me to be the person(s) named as assignor(s) or the
assignor’s authorized representative who executed this assignment and acknowledged voluntarily signing it.


Notary Public
My Commission expires:



ASSIGNEE:


Authorized Signature                                           Date


Name & Title (Print or Type)                                   Corporation/Company Name

UNITED STATES OF AMERICA                    )                  DOG Qualification File #
                                            )SS.
STATE OF                                    )

THIS CERTIFIES that on the                      day of ___                       , 20      , before me appeared
                                                       , known to me to be the person(s) named as assignee(s) or
the assignee’s authorized representative who executed this assignment and acknowledged voluntarily signing it.


Notary Public
My Commission expires:



APPROVAL



Kevin R. Banks, Director                                       Effective Date of Assignment
Division of Oil and Gas, DNR, State of Alaska

Recorder’s Office (optional)
                            Recording District                          Original lease recorded? ___ Yes ___No
After recording, please return to:                                      Prior document reference:

								
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