HomeMy WebLinkAbout20110535.tiff KERR-MCGEE OIL AND GAS ONSHORE DIVISION ORDER
Venture Number: 317820
Property Number: 1090402
Property Name: CURTIS 37-25 NB-CD _
Product: All Products
WELD COUNTY COLORADO Status: BEFORE PAYOUT ' t ED IS /. I.n.
County/State: WELD/CO
PO Box:758 Effective Date: DATES OF FIRST SALES
Owner Number: RV24096004-WELD COUNTY CGLt3$&ADQ-: -.£ tr.t'
GREELEY,CO 80632 Interest Amt/Type: 0.00510156/RI
Unit Description:
T5N-R66W
Sec.25: S/2SE/4
Sec.36: N/2NE/4
Weld Co.,CO
Containing 160.00 acs,m/I
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 COLORADO *Tax ID#84-6000813
**Tax ID#
ATTESY:15
Clerk to the Bo.rd wner Signature/Co orate Title Owner Address(if different from above)
BY: ,i nl "° � 1F�md :Barbara Kirkme er, Chair
Deputy C 4 •a Owner Signature/Corporate Title City,State Zip Code
970-356-4000 X4200
Owner Daytime Phone
t .
Out -WC
*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
Date Prepared: Fern 2011-0535
Return to: KERR-MCGEE OIL AND GAS ONSHORE P
P.O.Box 173779 Prepared by: Debbie Geary
Denver,CO 80217-3779 °LIZ
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:
Cow ty Attorney
DATE: 2 / 7 —l/
Anadarko Petroleum Corporation
Owner On-Line Access
To access your check/EFT statements on-line via the Internet. Go to ... WWW.Otidex.com
If you have not received a Check/EFT from Anadarko, Kerr McGee, Lance and Howell, no
information will be posted onto the oildex website.
Scroll down left side of page until you get to "Owner Relations Connect Websites" see below
Off 11dE.-'_X
teeFk9E `"sokfc s aT1 A -47:i ----ac: f iia »y; ?> ` 'ic , :G c _
,7.
Delivering infar<itidy
,
Improving processes. r •"`
Supporting better decisions. s<<: 70 Type II
CO
Coinect We:,ite,;
Gera Energy LLC Oildex is the energy industry's leading provider of digital data,
Anadarko N. workflow and spend analysis solutions,It provides the most
SP lti comprehensive solution for managing revenues,expenses and 4,200 Companies
Chevron U.S.R.
business intelligence. Us
44,000'Sets
Cra iocoPhilips
0evor,
orinim Today,more than 4200 companies depend on Oildex to help ¢e0bdion in transaction
t"o?,pesrnncee treamline their business processes,with services ranging detail Yearly
Click on Anadarko
Then click on View i}oaameca? a.iu :cpi tt c,, . i,ci : rig =vyli'. 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
t_,meusers: clickn_GI_. It will then prompt you to put in your Login and Temp Password
LOGIN is your Owner Number = Is your 6 digit Anadarko owner number (Example: RV12345604 or
JV12345601) APC/KMG owner numbers (Not the Payee #) are located at the top of your check detail.
To access oildex you only need to put in the six digit owner number123456, leave off the RV or JV and
NIthe O4 or 01 at the end if you are looking at a tax statement.
TEMP Password is normaly the last 6 digits of your Tax ID/Social Security # on your account.
(Example: SS# 123-45-6789 would be 456789) It will then prompt you to choose a password you
can remember. New Password must be at least 7 digits long. Be sure to write your new password down
and keep it in a safe place so not to forget it.
If you have any other problems accessing www.oildex.com please contact Oildex support directly at:
support('oildex.com or contact owner.relations aanadarko.com
1099 Misc Tax Form — go in the "Inbox" tab there is a place that states "Display 1099's" If you have
several owner numbers you will need to go to each Owner number.
Dear Interest Owner:
Enclosed are two copies of the Division Order or Transfer Order. An executed Division Order notifies
the interest holder about property information relevant to the mentioned well, and gives the operator
or payee the authorization to pay the owner based on the interest noted on the Division Order for
that particular well.
Please execute (sign in front of two witnesses) the original and retain the one marked "Copy"for
your records. Sign exactly as shown on the Division Order or Transfer Order. Signatures must be
witnessed by two people. A signature line has been provided for witnesses. 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.
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 does not match the name on your Social Security Card, please advise us, in
writing, of the differences.
Name, Address and Ownership Changes must be submitted in writing to the address listed below.
Please include proper documentation confirming the change:
❑ For Name Chances: Marriage Certificate, Divorce Decree, etc.❑ For Ownership Chances: Deeds, Assignments, etc., must be recorded in the County (Parish) in
which the property is located prior to sending them to our office. The copy of the document sent in
must have evidence of the recording (e.g., the recording stamp) on it.
❑ For Chances 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.
❑ Address chances Provide your Owner Number, Social Security Number, both the old address AND
new address and new telephone number. Please note that Royalty Checks ARE NOT forwarded by
Post Office.
Please address all correspondence, including your executed Division Order, to the
following address:
Kerr—McGee Oil &Gas Onshore
Attn: Division Orders
P.O. Box 173779
Denver, CO 80217-3779
Anadarko Customer Relations toll-free telephone number: 1-800-359-1692. Our Customer Relations
Agents are available between 9:00 to 11:00 am and 2:00 to 4:00 pm, CST, Monday Through Friday. Outside
those hours, or in times of exceptional call volumes, you will be directed to leave a voice message. Our goal is
to return your call within 48 hours
When you wish to make an inquiry, please have available as much of the following information as you can:
o Owner Number
o County and State where well is located
o Well name and/or property number
o Your telephone number with AREA CODE
CUSTOMER WEBSITE: https://connect.oildex.com/apc. (instructions are listed on the back of
this letter) For Technical Questions related to this website please call: 1-888-922-1222
ext. 191
Direct Deposit: In order to improve our payment process Anadarko Petroleum Corporation and its
subsidiaries have implemented an optional Direct Deposit program that will enable you to receive electronic
funds transfers (EFT) in lieu of mailing revenue checks. If you choose to enroll in this program, you will still
receive your check detail in the mail. Please call our Customer Relations Hotline 1-800-359-1692 ask for EFT
information.
Hello