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NADOA Model Form Division Order (Adopted 9/95)
DIVISION ORDER
To: Petroleum Development Corporation
1775 Sherman Street, Suite 3000
Denver, CO 80203
Attn: Michelle Morley (303) 831-3914 or mmorley@petd.com
Property Number: 08758
Property Name: Kinzer 28LD NBCD
Operator: Petroleum Development Corp
County and State: Weld, Colorado
Property Township 5 North, Range 67 West
Description: Section 28: SWSW
Production:
X
Oil
X
Gas
X
Date: March 20, 2009
Effective Date: March 10, 2009
Other: all products
Owner Name
and Address:
See `Exhibit A' attached hereto and made a part hereof
OWNER NUMBER:
Type of Interest:
Decimal Interest:
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by Petroleum
Development Corporation (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 $50.00, or pay yearly 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.
Special Clauses:
Owner(s) Signature(s):
Owner(s) Tax I.D. Number(s): 84-6000-813
Owner Daytime Telephone
Owner FAX Telephone #:
970-356-4000 X4200
Attached Exhibit)
Liam F.Garcia, Chair
04/22/2009
Deputy Clerk to the B
970-352-0242
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 31 % tax withholding and will not be refundable by Payor
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Retain this copy for your records
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Exhibit A
08758 - Kinzer 28LD NBCD
Owner No.
Credit To Type Interest
43444
Weld County Brd Of Comm
PO Box 758
Greeley, CO 80632-0000
RI 0.00084375 << Your Interest
Petroleum Development Corporation
March 20, 2009
Re: Kinzer 28 LD NBCD Division Order
T5N-R67W,Secuun 28: S/2SW/4 and Section 33: N/2NW/4
Weld County, Colorado
Dear Interest Owner:
Enclosed please find a Division Order for the Kinzer 28LD NBCD well which went online earlier
this month. Please note that the Kinzer 28LD is a 318Ae well and is spaced on a 160 acre unit
covering the S/2SW/4 of Section 28 and N/2NW/4 of Section 33 in Township 5 North, Range 67
West, Weld County, Colorado. Your division of interest has been calculated based on your interest
percentage within this 160 acre unit.
Please follow the enclosed "Instructions to Interest Owners" for executing and returning one
original of the Division Order to me. I have enclosed a pre -paid envelope for your convenience.
The extra original is for your records.
Please feel free to contact me at mmorley@petd.com or (303) 831-3914 if you have any questions or
concerns regarding the calculation of your interest.
Sincerely,
PETROLEUM DEVELOPMENT CORPORATION
Michelle Morley
Division Order Analyst
/m2
Enclosures
L OWE
CORPORATE OFFICE:
Petroleum Development Corporation
120 Genesis Boulevard • P.O. Box 26
Bridgeport, WV 26330
304-842-3597
DENVER OFFICE:
Petroleum Development Corporation
1775 Sherman Street, Suite 3000
Denver, CO 80203
303-860-5800
EVANS OFFICE:
Petroleum Development Corporation
3801 Carson Avenue
Evans, CO 80620
970-506-9272
INSTRUCTIONS TO ALL INTEREST OWNERS
Dear Interest Owner,
Petroleum Development Corporation has enclosed a Division Order for your execution.
The attached document should not be altered in any way except to correct spelling errors, unless accompanied by
documentary evidence to support the change.
If your name and interest are correctly shown:
I. Sign your name as shown on the Division Order.
2. If your name has changed due to marriage or divorce, execute the Division Order using your present name and furnish a copy
of the marriage certificate or divorce decree.
4. If signing for a corporation, signature must be attested, corporate seal fixed and title of signatory party reflected.
5. If signed by agent, attorney -in -fact, guardian or any party other than the named interest owner, a certified copy of the power
of attorney or other evidence of such party's right to sign must be furnished.
6. Your correct mailing address should be noted in the space provided to insure prompt receipt of production proceeds.
7. The top copy or the "Original" of the Division Order should be returned to:
Petroleum Development Corporation
1775 Sherman Street, Suite 3000
Denver, Colorado 80203
Attn: Division Orders
8. Should you have any further questions regarding the enclosed Division Order, please contact Petroleum Development
Corporation at (303) 860-5836 or (888) 860-5836.
9. Please DO NOT DETACH the exhibit from the Division Order or Transfer Order if one is included.
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.
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