HomeMy WebLinkAbout20101286.tiff DIVISION ORDER
To:ENCANA OIL & GAS (USA) INC Property No.: 36400
370 17th Street, Suite 1700 Property Name: SOSA 21-18 (J)
Denver, CO 80202 Field:
Reservoir:
Date: 05/04/2010
Initials: kim.lf
The undersigned certifies the ownership of their decimal interest in production or proceeds as described below payable by
ENCANA OIL & GAS (USA) INC.
ENCANA OIL & GAS (USA) INC 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.
ENCANA OIL & GAS (USA) INC 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 ENCANA OIL & GAS (USA) INC any amount attributable to an interest to which the undersigned is not entitled.
ENCANA OIL & GAS (USA) INC may accrue proceeds until the total amount equals $25.00, or pay annually, 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 ENCANA OIL & GAS (USA) INC
may have certain statutory rights under the laws of the state in which the property is located.
Property Number: 36400 Effective Date: 11/13/2007
Property Name: SOSA 21-18 (J)
Operator: EnCana Oil & Gas (USA) Inc
County and State: WELD, COLORADO
Property Description: T1N R68W 6TH PM
Sec 18 W2
320.00 Acre Spacing Unit
OWNER NO DECIMAL INTEREST TYPE INTEREST
2101559 0.00114869 GI - GOVERNMENT INTEREST
OWNER NAME/ADDRESS
Weld County Colorado Board of County
Commissioners
PO Box 758
Greeley, CO 80632
84-6000813
(S) ST�a_TURE/TST B:
Douglas Ra. -m.. her, Chair JUN 1 4 2010
Said of Weld County Commissioners
DATE: 06/14/2010
OWNER TELEPHONE NO.: 970-356-4000 X4200 84-6000-813
SOCIAL SECURITY OR TAX ID NO.
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number. Failure to comply will
result in 28% tax withholding and will not be refundable by Payor.
etitAtPAa a F Db a-1
2010-1286
ENCANATM
370 17th Street rr: (303)623-2300
Suite 1700 fax, (303)623-2400
Denver,CO 80202 www.encana.com
EnCana Oil & Gas (USA) Inc.
May 4, 2010
RE: Sosa 21-18(J)
T1N-R68W-Section 11
Weld County,Colorado
Dear Interest Owner:
The captioned well is currently producing from the J Sand (J), Codell (C), and Niobrara (N) formations. Enclosed,
please find two copies of our Division Order that reflect your current ownership. The Division Order allows you to
verify your decimal interest or the percentage of the proceeds from the sale of production, and authorizes EnCana to
pay you that percentage according to its terms. Nothing in a Division Order modifies the terms of your lease, or in
the case of an overriding royalty or production payment, the agreement under which you received your interest.
Please review the division order for completeness and accuracy, sign in accordance with the enclosed instruction
sheet and return one copy to EnCana in the stamped,self-addressed envelope provided. You should retain the extra
copy for your personal records.
Upon receipt of the signed Division Order, your interest will be placed in a pay status, and payment will be released
in the next month's pay cycle if the amount is greater than $25. Please be sure to provide your Social Security or
Tax Identification Number, otherwise federal law requires that EnCana deduct backup withholding from your revenue
payments, currently at a rate of 28%. Note that these monies will not be refundable by EnCana.
Should you have any questions, please contact me at(720)876-5246 or via our owner hotline at(866)917-3700.
Sincerely,
EnCana Oil &Gas(USA) Inc.
gvoi.v:„.. Cu/sire
Kim West
Division Order Analyst
South Rockies Business Unit
TM Trade,Mark of EnCana Corporation. Used under license.
INSTRUCTIONS TO ALL INTEREST OWNERS
READ CAREFULLY BEFORE SIGNING
This Division Order should not be altered in any way unless accompanied by documentary evidence to support the
change.
IF YOUR DIVISION ORDER INCLUDES AN EXHIBIT"A", DO NOT REMOVE THE EXHIBIT"A" FROM THE COPY
RETURNED TO THIS OFFICE.
If the name and interest are correctly shown:
Signature: Sign name exactly as shown on the Division Order. If your name has changed due to
a marriage or divorce, sign the Division Order with your current name and send a
copy of the marriage certificate or divorce decree with your signed Division Order.
If the interest is owned by a partnership, the Division Order must be signed by the
general partner or managing partner.
If the interest is owned by a corporation,the Division Order must be signed by a duty
authorized officer.
If the Division Order is to be signed by an agent, attorney-in-fact, guardian, estate
representative, trustee or any other party other than the named interest owner,
please provide a copy of the Power-of-Attorney or other evidence of authority by
Payor.
Taxpayer's I.D.or S.S.N.: Insert your number in the space provided. Federal law requires you to furnish your
Social Security or Taxpayer Identification Number. Failure to comply will result in 28%
tax withholding and will not be refundable by Payor.
Mailing Address: Indicate, in the space provided, the address to which checks will be mailed. Do not
abbreviate.
Change of Address: You should notify us promptly of any change in your mailing address. This notice
must be over your own signature, or the signature of your appointed agent. Always
include your owner number, old address, and then state your new address with zip
code.
RETURN THE EXECUTED INSTRUMENT WITHOUT DELAY TO THE ADDRESS BELOW.
KEEP ONE COPY FOR YOUR RECORDS.
EnCana Oil &Gas (USA) Inc.
Attn: Division Orders—South
37017th Street, Suite 1700
Denver, CO 80202
•
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:
Cou Attomey
77�� DATE: e' '� �/�
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