HomeMy WebLinkAbout20073406 DIVISION ORDER
WALSH PRODUCTION INC Date : 10/04/2007 11 :40 am
C/O EXTEX DIVISION ORDER SRVCS
17301 W COLFAX AVE STE 406
GOLDEN CO 80401
WELD COUNTY CLERK TO THE BOARD
915 10TH ST Owner Number: 10287X
GREELEY CO 80632 Type of Interest : R
Decimal Interest : 0 .12500000
Property #: 18201X Property Name : WELD #5-28
Effective Date: 11/01/07 Operator: WALSH PRODUCTION INC
Legal Description: TOWNSHIP 11 NORTH - RANGE 61 WEST
SECTION 28: SW/4 NW/4
WELD COUNTY, COLORADO
Production: Oil :Y Gas :Y
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above.
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 $25.00, or pay annually whichever occurs first,
or as required by applicable state statutes.
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 und the laws of the state in which the property is located.
Owner SignaturescAki
Owner Tax ID Number 84-6000-813 OCT 3 1 2007
Owner Daytime Telephone (970) 356-4000 Ext 4200
Owner Mailing Address 915 10th Street, P.O. Box 758
Greeley, Colorado 80632
Your copy
Federal Law requires you to furnish your Social Security or axpayer Identification Number:
Failure to comply will result iu 28% tax withholding and will not be refsadeble'by Payor. . Ze eg_
etyaid ff l & 2007-3406 �l
(01311300 7 -D,7-2.-0r7
ExTEX
Land and Administration LLC
17301 W Colfax Ave,No 406 303-463-8799
Golden,CO 80401 FAX 303-463-8808
Dear Interest Owner,
The enclosed Division Order has been prepared on the basis of documentation
provided.
Please examine the Division Order for accuracy. If you are in agreement with the
interest set forth, execute the original, retaining the copy provided for file and
future reference. A correct mailing address and Social Security or Tax
Identification Number is required and should be included in the spaces provided.
The executed original should then be returned to our office.
Upon receipt of the properly executed Division Order, your interest will be placed
into pay on the 20th day of the following month, providing that the accruals to
your interest amount to at least $25.00.
Please refer to our lease number and your owner number in any communication
with our company so that we can respond promptly.
Very truly yours,
Extex Land and Administration LLC
Dennis M.Pade Chris C.Pennels Boyd S.Sanstra
President Vice President Vice President
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 applicle.
BY:
Coun omey
DATE: 7'2 f -]
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