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NADOA Model Form Division Order(Adopted 9/95)
a noble DIVISION ORDER
energy
WELD COUNTY
COMMISSIONERS
Return To: Noble Energy,Inc. Desk Code: HES/ntt
1625 Broadway,Suite 2200 7 12 FEB-q ADM':00 February 6,2012
Denver,CO 80202 Effective Date See Attached Exhibit"A"
Property Name: See Attached Exhibit"A" RECEIVED
Operator: NOBLE ENERGY,INC
County and State: Weld County,CO
Property Description: See Attached Exhibit"A"
Product: ALL
OWNER NAME/ADDRESS PROPERTY# OWNER# INTEREST
WELD COUNTY COLORADO
%BOARD OF COUNTY COMM
WELD CO CENTENNIAL CENTER See Attached Exhibit"A" 124102.1 See Attached Exhibit"A"
1150 0 STREET
GREELEY,CO 80632
The undersigned certifies that ownership of their decimal interest in production or proceeds as described above payable by Noble
Energy Inc.(Noble).
Noble 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.
Noble 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 Noble any amount aOributable to
an interest to which the undersigned is not entitled.
Noble may accrue proceeds until the total amount equals$25.00,or pay proceeds with a balance of$10.00 or more annually in
September of each year,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 Noble may have certain statutory rights under the
laws of the state in which the property is located.
Special Clauses: OWNERS)
S OUNTY COLORADO
:::
eigna 6t6 'cial Security or Number:): 84-6000-813
TIN(s)or SSN(s)
Owner Daytime Telephone No.: 970-336-7204 Owner Fax No.: 970-352-0242
Address: 1150 0 Street, P.O. Box 758, Greeley, Colorado 80632
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Dear Interest Owner,
Please read carefully before signing the enclosed oil and gas division orders:
1. Your interest as shown on this instrument should not be altered in any way unless
accompanied by documentary evidence to support the change. We may reject any
division orders changed without our approval
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2. Furnish in writing any change of address information and include your signature.
For change in ownership, furnish copies of properly filed and recorded legal
documents affecting title of interest ownership under which payment is made.
Prove a letter describing effect of change.
3. Sign your name EXACTLY AS IT APPEARS ON THE INSTRUMENT.
4. If signing for a corporation, signature must be attested, corporate seal affixed and
title of signatory party shown.
5. If the instrument is signed by an agent, attorney-in-fact, guardian, estate
representative,trustee or any party other than the named interest owner, we must
have evidence of the rights vested in the signatory party.
6. If an interest is shown jointly for more than one person, each party must sign the
division order in the manner that his or her name is shown thereon. In the event
one party has been designated agent for the joint interest shown or he/she has
been granted a power of attorney for the other party(ies), we must have evidence
to this effect.
7. Insert your Tax Identification Number or Social Security Number, whichever is
applicable, in the space provided. We may withhold payment until such number
is received.
8. Confirm the address to which checks are to be mailed. If different, please provide
the correct address. You should notify us promptly of any changes in your
mailing address.
9. Return the executed instrument without delay to the address below.
RETURN SIGNED DIVISION ORDER TO:
NOBLE ENERGY INC.
ATTENTION: NEIL TINKHAM
1625 BROADWAY, SUITE 2200
DENVER, CO 80202
WITH QUESTIONS OR CONCERNS
REGARDING YOUR DIVISION ORDER
PLEASE CONTACT CLAUDIA CRAIGHEAD
DIRECT: 303-228-4126 FAX: (303)228-4287
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: /ig4ta
k-KCoufity Attorney
DATE: 2 -/4-1Z
Stephanie Arries
From: CCraghead@nobleenergyinc.com
Sent: Tuesday, February 14, 2012 1:01 PM
To: Stephanie Arries
Subject: Sekich
I hope this information will help.
Drilling and Division Order Title Opinion
Certified to March 11, 2010 at 7:00 a.m.
T3N. R67W of the 6th P.M.
Section 18: SE/4SW/4, SW/4SE/4
Section 19: NE/4NW/4, NW/4NE14
Weld County. Colorado
Sekich P19-28D well
Recorded: July 20, 1970 in Book 630 at Reception No. 1551545
Lessor(s): Weld County, a political subdivision of the State of Colorado, by the Board of County Commissioners, for its
respective interest
Lessee(s): Leland S. Vance
Lands Described: T3N. R67W. 6th P.M. • . <.
Sec. 19: A strip of land 30' wide on North side of NW/4 (1.82 acres)
• <<
Kind regards,
Claudia Crag head
Division Order Specialist
Noble Energy, Inc.
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