HomeMy WebLinkAbout20090962.tiffKERR-MCGEE OIL AND GAS ONSHORE DIVISION ORDER
Venture Number: 322088
Property Number: 3032127
Property Name: CHAVERS 14-18A NB -CD
Product: All Products
WELD COUNTY BOARD OF COMMISSIONER Status: NOT APPLICABLE
County/State: WELD/ CO
915 10TH STREET - Effective Date: DATE OF FIRST SALES
Owner Number: RV37471404 - WELD COUNTY BOARD OF COMMISSIONER
GREELEY, CO 80632 Interest Amt/Type: 0.00007812 / RI
Unit Description:
TIN R66W SEC 18: SESW
CODELL NIOBRARA FORMATION - 80 AC SPACING
SEC 18: E2SW
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)
ATTES
BY:
Dep
WELD COUNTY BOARD OF COMMISSIONER
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and
*Tax ID # 84-6000813
**Tax ID #
Owner Signature/Corporate Title Owner Address (if different from above)
William F. Garcia, Chair
04/22/2009
City, State Zip Code
970356-4000 X4700
Owner Daytime Phone
" Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance v& federal law and any tax withheld will not be rorundable by payor.
"Insert Tax ID number for all individual parties listed above in the Name and Address box
Return to. KERR-MCGEE OIL AND GAS ONSHORE
P.O. Box 173779
Denver, CO 80217-3779
1-800-677-5603
Date Prepared: March 21, 2009 /-' O /17
UX
Prepared by: Tena Murphy C -C�/
rc`�- r/e,4
Dear Interest Owner:
Enclosed are two copies of the Division Order or Transfer Order. Please execute (sign in front of
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. 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.
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
Address changes must be signed by the owner and submitted to the above address. 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 the Post Office.
Name and Ownership Changes must be submitted in writing to the above address. Please include
proper documentation confirming the change:
❑ For Name Changes: Marriage Certificate, Divorce Decree, etc.
❑ For Ownership Changes: 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 Changes 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.
When you wish to make an inquiry or request a change, please have available as much of the following
information as you can:
(1) Owner Number
(2) County and State where well is located
(3) Well name and/or property number
(4) Your telephone number with AREA CODE
Anadarko Customer Relations toll -free telephone number: 1-800-359-1692.
Or, you can access our CUSTOMER WEBSITE: httos://connect.oildex.com/aDc.
For Technical Questions related to this website please call: 1-888-922-1222 ext. 191
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.
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' I1
/SO, Cou ty Attorney
DATE 7-12 -C ?
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