HomeMy WebLinkAbout20120363.tiff KERR-MCGEE OIL AND GAS ONSHORE DIVISION ORDER
Venture Number: 318544
Property Number: 3039539
WELD COUNTY Property Name: OCKER 3-19A NB-CD
COMMISSIONERS Product: All Products
WELD COUNTY BOARD OF COMMISSIONER Status: NOT APPLICABLE
2812 JAN 30 A I 514 County/State: WELD/CO
PO Box: 758 Effective Date: DATES OF FIRST SALES
RECEIVED Owner Number: RV37471404-WELD COUNTY BOARD OF COMMISSIONER
GREELEY,CO 80632 Interest Amt/Type: 0.00211289/RI
! Unit Description:
TIN R66W SEC 19:NENW(SURF)&(BTU
CODELL NIOBRARA FORMATION SEC 19:N2NW
80 AC SPACING(ACTUAL 82.825 ACS)
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$100,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)
WELD COUNTY BOARD OF COMMISSIONER *Tax ID#XXX-XX-0813
**Tax ID#
r"
Attest. ^��•�S m171�� C J -
Clerk t o the o: �;Owner Signature/Corporate Title Owner Address(if different from above)
By: ��J/ ./ ,_ % Sean P. Conwa , Chair
Deputy Cler @k1 er Signature/Corporate Title City,State Zip Code
" FEB 0 6 2012
,n® ,
Owner Daytime Phone
moo/J-0. 63
"Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withheld will not be refundable by payor.
""Insert Tax ID number for all individual parties listed above in the Name and Address box
(_ Cello
Return to: KERR-MCGEE OIL AND GAS ONSHORE Date Prepared: January 24,2012
P.O.Box 173779 C' ' ' ` $13 kur h'lGAti Prepared by: Tena Murphy
Denver,CO 80217-3779 p'1- rj- I oZ Susp: N
1-800-677-5603
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, legal description, and percentage
of royalties, if applicable.
BY: .l'�/'4 dta
1/4/1#-County Attorney
DATE: 0) -07 -72-
Anadarko Petroleum Corporation
Owner On-Line Access
To access your Anadarko Petroleum Corporation and/or it's subsidiaries such as Kerr McGee, Howell, etc
royalty check/EFT statements. In addition to viewing and printing your check detail, you will be able to
create simple revenue reports, get answers to frequently asked questions, pull copy of your 1099 Misc Tax
form and prepare change of address forms on-line via the internet. Go to ... www_oildex.com
Scroll down left side of page until you get to"Owner Relations Connect Websites"see below Click on
"Anadarko".
6lld l.'X O*Payables O*Budgeting C;*Revenue 0*Statements C) t7UM Login
owiri ewmi„ns.�n,�a Alirops.:11rr,
• Simplify the way manage and analyze revenue
production.
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production,and coo st information ". ,
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Oildex-proven technology to transform the business of energy
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Then click on View Documents and Reports - tclick here to login Log in here and it will prompt you to
put in your Login and password. NOTE: If you are a first time user be sure to click on First-time
users: click here! . It will then prompt you to put in your Login and Temp Password (see below
instructions)
First time users (Please note a check/EFT must be issued first before an Oildex account is
set up. If you have not received a royalty check no information will be posted in oildex.)
Please be sure to click on " I am a first time user " then
User ID = (Your 6 digit Owner Number. Do not include the RV or O4 at the end, that is for internal use
only.)
Temp Password = (typically the last six digits of Social Security Number (SSN) or Tax ID Number
(TIN) associated with the account * (or a unique temporary password, see below)
Then it should prompt owner to put in a permanent password, must be at least 6 alphanumeric
characters. A confirmation email which will include the password you have chosen will be emailed to you.
* (We subscribe to Oildex and they are requested to use the last 6 digits of SSN/ TIN as the Temp password,
however, we have found that in some cases if Oildex does not have the SSN/TIN at the time of set up they will
choose a unique temp password other than the last six digits of SSN/TIN. In this case the owner may call or e-
mail CRM-Revenue@ianadarko.com 1-800-359-1692, Option 2. Please note we will require the
ft* Owner Number along with the SSN / Tax ID # associated with the account in order
to provide you with the Temporary Password.)
If you have any other problems accessing www.oildex.coni please contact Anadarko Petroleum Corp. at
CRM-Revenue@anadarko.com or Oildex support directly at: support@)oildex.com
a Check out the new Anadarko Owner Relations Website: Go to www.anadarko.com click on
1 - About Anadarko, then click on Owner Relations. Our new owner relations website provides
details in regards to owner issues. This is a helpful tool to utilize for issues about royalty checks,
owner interest questions and much more!
Dear Interest Owner:
1. Enclosed are two copies of your Division Order or Transfer Order. Please execute the first copy in front of two
witnesses and provide a valid Social Security Number or Tax Identification number. The second copy marked
"Copy" is for your records.
a. Sign exactly as shown on the Division Order or Transfer Order. Signatures must be witnessed by two
people. If joint ownership, all owners will be required to sign, but may sign separate copies.
Signatures by Agents, Attorneys-in-Fact, Guardians or Trustees must be verified by attaching evidence
of the right to sign in that manner, such as a copy of the Power of Attorney.
b. Include the correct Social Security Number or Tax Identification Number in the space provided.
Failure to furnish this information may result in withholding tax in accordance with
federal law and any tax withheld will not be refundable by payor. If the name on the Division
Order or Transfer Order does not match the name on your Social Security Card, please advise us, in
writing, of the differences.
2. Please address all correspondence, including your executed Division Order, to the following address:
Kerr McGee
Attn: Division Orders
P.O. Box 173779
Denver, CO 80217-3779
3. For CHANGE OF ADDRESS, please submit all changes to the above address. All ADDRESS CHANGES
MUST BE MADE IN WRITING.
4. NAME AND OWNERSHIP CHANGES must be submitted in writing to the above address.
In order to process the name and ownership changes, we require the following documentation:
a. Name Changes: Marriage Certificate, Divorce Decree, etc.
b. Ownership Changes: Deeds, Assignments, etc., must be recorded in the County (Parish) in which
the property is located prior to sending them to our office. Copy of the document sent in must have
evidence of the recording (e.g., the recording stamp) on it.
c. Changes due to Death of an Owner: As a general rule, we require complete copies of probate
proceedings rendered by a court having jurisdiction over the property in question. If the Estate was
not probated, or if it was probated in a different state, other documentation may be required.
5. Anadarko Customer Relations toll-free telephone number: 1-800-359-1692. Our Customer Relations
Agents are committed to monitoring and returning calls in a timely manner. Our goal is to return your call
within two business days.
6. When you wish to make an inquiry or request a change, please have available as much of the following
information as you can:
-Owner Number
-County and State where well is located
-Well name and/or property number
-Your telephone number with AREA CODE
7. For access to check history information: http://www.oildex.com, or refer to the attached instruction sheet.
For Technical Questions related to this website please call: 1-888-922-1222 (option 3).
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