HomeMy WebLinkAbout20082948.tiff KERR-MCGEE OIL AND GAS ONSHORE DIVISION ORDER
Venture Number: 322089
Property Number: 3032130
Property Name: BRATTAIN MABLE UNIT 2 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 COMMISSION:
GREELEY,CO 80632 Interest Amt/Type: 0.06250000/RI
Unit Description:
T3N-66W SEC 20:NW/4 COVERING 160 ACRES M/L OF THE
NIOBRARA CODELL FORMATION
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 BOARD OF COMMISSIONER *Tax ID#84-6000813
**Tax ID#
Attest: /IL/2d 915 10th Street
C le k t 9il . 'BCY•'!'Ql - Owner Signature/Corporate Title Owner Address(if different from above)
B / . ,I ,y i �. William H. Jerke, Chair Greeley, Colorado 80631
Deputy V- tP ''the r, :oa -. Owner Signature/Corporate Title City State Zip Code
970-356-4000 X4200
Owner Daytime Phone
/1—O5 -OFs- '• AltRkCicnuS) /l {7s-oa"
*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
. aao6
Return to: KERR-MCGEE OIL AND GAS ONSHORE Date Prepared: October 22.2008
1099 18th St.Suite 1800 Prepared by: Kai 2008-2948
Denver,CO 80202-1918
1-800-677-5603
KERR-MCGEE OIL & GAS ONSHORE LP 1099 18TH STREET • DENVER, COLORADO 80202
720-929-6000
�1J KerrAtGee
INSTRUCTIONS FOR EXECUTION OF OIL AND GAS DIVISION ORDER
Please read the following instructions carefully before signing the enclosed Division Order:
1. Be sure that your interest is correct.
2. Sign your name in the space provided exactly as it is shown BEFORE TWO
WITNESSES.
3. Your SOCIAL SECURITY NUMBER or TAX IDENTIFICATION NUMBER
must be shown in the space provided. Failure to provide the number may result in
withholding of your production proceeds, as required by law, and you may also be
subject to a penalty imposed by the Internal Revenue Service.
4. Verify the address to which checks should be mailed.
5. If the interest is owned by a CORPORATION, the Division Order must be signed by a
duly authorized officer and attested. The corporate seal must be affixed and the title of
the signing officer shown.
6. If the interest is owned by a PARTNERSHIP, the Division Order must be signed by the
general partner or managing partner and evidence of such authority to sign must be
finished.
7. If the Division Order is signed by anyone other than the named owner such as an
AGENT, ATTORNEY-IN-FACT, or GUARDIAN, evidence of authority must be
provided.
After you have completed and signed the Division Order, please return the original to us.
The copy is for your records. Should you have any questions, please do not hesitate to call.
KERR-MCGEE OIL & GAS ONSHORE LP
A SUBSIDIARY OF
ANADARKO PETROLEUM CORPORATION
KATIE PETROSS, CONTRACT ANALYST
1099 18TH ST
DENVER CO 80202
(720) 929-6000
A SUBSIDIARY OF ANADARKO PETROLEUM CORPORATION
•
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.
y6v á0rney
DATE: l9 _$/ —OK
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