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COLORADO STATE BOARD OF LAND COMMISSIONERS <br />ASSIGNMENT RECORD <br />FULL ® PARTIAL ❑ ASSIGNMENT OF LEASE NO. SoZ <br />1. In consideration of Ten dollars ($10.00) and other valuable consideration `_ _ iy „� 4k,-.57- <br />(Assignor, pl ase print or type <br />2. the within named lessee(s), does (do) hereby assign, transfer and (or) sell all rights, title, interest and (or) claim in and <br />3. to this lease in its entirety, or <br />(No. of acres m/l) <br />namely the of the Section, <br />(Subdivision of Section) <br />4. Township and Range described in this lease, unto f4—LgVV4W7_ Pih/1-14 4110 *Al' -M /whose <br />(Assignee, please print or type) f <br />5. address is 176 JW/ &'Y E�Oa�G/ S- <br />'4'L— <br />(Street, Buildin or P. O. Box No) (City) (State) 1 <br />6. who will be the new lessee of record for all, or that part of this lease above described, to have, hold and enjoy all rights <br />7. and covenants of this lease and who will accept and abide by all laws, rules, regulations and responsibilities pertinent <br />8. to and (or) co e8��pped herein and in said lease henceforth from 12:00 noon on this "day of V/)_ 9s� A.D. <br />9. e`er �itetas.l _ /J <br />(Signature'of-Assignor) <br />10. G� G�t/ti S% U. S, <br />(Seal or Authority) <br />11. Signed and acknowledged before me this _,46Wday of Zr J Jc —,A.D., o?4315 <br />12. My commission expires ,i� �-�_ a , A.D., &0l <br />(Seal) ISTIAT-ET8, R L R <br />. (�1(� App RY ID 2006102itS7a <br />A "'Ap/ .1e Z___ <br />s�ON 2ot7 O ' RYPUBLIC <br />13. <br />/J 1 (Signature of Assignee) <br />14. <br />(Seal or Authority) <br />15. Signed and acknowledged before me this A6'� day of /.//.LI�i P A.D., <br />16. My commis x; / A.D., <br />(Seal) <br />COMMiSSirn r-x,1r ^ 111A1,701e <br />,A /)," '"; <br />OTARYP C <br />APPROVAL OF ASSIGNMENT <br />This Assignment approved by order of the State Board of Land Commissioners this 1st day of August A.D. 2013 . <br />Recommended <br />- <br />Phil'Cdurtne , Solid Minerals Leasing Mgr. <br />AnnrnvM <br />Page 1 of] <br />