HomeMy WebLinkAbout20110788.tiff KERR-MCGEE OIL AND GAS ONSHORE DIVISION ORDER
Venture Number: 317818
.-•t Property Number: 1090400
- ^ Property Name: CURTIS 23-25 NB-CD
Product: All Products
WELD COUNTY COLORADQ-: „ I in. r5Status: BEFORE PAYOUT
County/State: WELD/CO
PO Box: 758 Effective Date: DATES OF FIRST SALES
4 . ._-.r Owner Number: RV24096004-WELD COUNTY COLORADO
GREELEY,CO 80632 Interest Amt/Type: 0.00587501 /RI
Unit Description:
T5N-R66W
SEC.25: E/2SW/4,W/2SE/4
CONTAINING 160.00 ACS,M/L
WELD COUNTY,CO
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#
ATTEST: ��!!��jj yam' UGhA ,
Cler u tD the oar Owner Signature/ rporate Ti le Owner Address(if different from above)
BY: b' lit Barbara Kirkmever, Chair
Deputy Cl ' to t,H ,. $FA Owner Signature/Corporate Title City,State Zip Code
ilf 'a, CY"'
w\4L ' Owner Daytime Phone
1861 ii i'...,„.„,,:z4
*Failure to famish 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 + rooce
Return to: KERR-MCGEE OIL AND GAS ONSHORE Date Prepared:March 08,2011
P.O.Box 173779 Prepared by: Debbie^---^"
Denver,CO 80217-3779
2011-0788
1-800-677-5603
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