HomeMy WebLinkAbout20130728.tiffKERR-MCGEE OIL AND GAS ONSHORE
DIVISION ORDER
Venture Number: 328269
Property Number: 1098578
Property Name: OVERLOOK 21-30 NB -CD
Product: All Products
WELD COUNTY BOARD OF COMMISSIONER Status: BEFORE PAYOUT
County/State: WELD/ CO
PO Box: 758 Effective Date: DATES OF FIRST SALES
Owner Number: RV37471404 - WELD COUNTY BOARD OF COMMISSIONER
GREELEY, CO 80632 Interest Amt/Type: 0.03570092 / RI
Unit Description:
T2N-067W, Sec 30: E/2NW/4 & W/2NE/4 COVERING 160 ACRES,
M/L OF 'HIE NIOBRARA CODELL FORMATION
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by
KERR-MCGEE OIL AND GAS ONSHORE (Payor).
Payor shall be notified, in writing, of any change in ownership, decimal interest. or payment address. All such changes shall be
effective the first day of the month following receipt of such notice.
Payor is authorized to withhold payment pending resolution of a title dispute or adverse claim asserted regarding the interest in
production claimed herein by the undersigned. The undersigned agrees to indemnify and reimburse Payor any amount
attributable to an interest to which the undersigned is not entitled.
Payor may accrue proceeds until the total amount equals 1100, or Sept. 30 whichever occurs first, or as required by applicable
state statute.
This Division Order does not amend any lease or operating agreement between the undersigned and the lessee or operator or
any other contracts for the purchase of oil or gas.
In addition to the terms and conditions of this Division Order, the undersigned and Payor may have certain statutory rights
under the laws of the state in which the property is located.
Note: NADOA Model Form Division Order (Adopted 9/95)
RV37471404
WELD COUNTY BOARD OF COMMISSIONER
Attest : m'w-stale. ,
Cl = k to he Board Ow VCr Signature/Corporafe Title�
By:
ri r'lliaui F. Garcia, Chair
�.... ...• 4.1 �.
Deputy Cie
*Tax ID ft XXX-XX-0813
**Tax ID iF
Owner Address (it different from above)
Signature/Corporate Title City. State Zip Code
MAR 1 8 2013
970-356-4000
Owner Daytime Phone
2013-0728
*Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withhele wn1 not ne reruneaoie oy payui.
**Insert Tax ID number for all individual parties listed above in the Name and Address box
Consen i Gt4endCt
vitt
KERB-MCGEE OII, AND GAS ONSHORE
P.O. Box 173779
Denver, CO 80217-3779
1-800-677-5603
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Date Prepared: March 06, 2013
Prepared by. Kr)
St,:
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COUNTY ATTORNEY STAFF APPROVAL
This is to affirm the attached Division Order and authorization to receive
payment for an oil and gas well has been reviewed by the County
Attorney's staff as to form and legal description.
a.- Nei LM) k> 2-1-30 34 6- CO
Assis nt County Atto ey
Date of signature: \--? -7
Additional Comments:
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