HomeMy WebLinkAbout20041645.tiff OIL AND GAS DIVISION ORDER
OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: May 12,2004
1999 BROADWAY, SUITE 3600 Effective Date: Date of First Production
DENVER,CO 80202 Well Number: 920461
(303)296-3600
Well Name: HSR-FITZPATRICK 4-20A for your files
Description: 3N-66W 20 NW/NW SPACING: NV2 Copy
Formation: J Sand
County and State: Weld County, Colorado
Owner: Address: Decimal Interest:
WEL210 915 10TH STREET 0.03125000 GAS RI
WELD COUNTY BOARD OF GREELEY CO 80632 0.03125000 OIL RI
COMMISSIONER
The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by Kerr-McGee Rocky
Mountain Corporation.
Kerr-McGee Rocky Mountain Corporation shall be held harmless in the event of, and is hereby released from any and all damage or loss which
might arise out of any overpayment or underpayment. The Owner executing this Division Order, in consideration of payments by Kerr-McGee Rocky
Mountain Corporation, agrees to pay any overriding royalty or royalty owners and/or all other persons who may have right, title or interest in the
interest in production set out above and further agrees to protect, indemnify and hold Kerr-McGee Rocky Mountain Corporation harmless from and
against any and all loss, cost or expense which it may suffer or sustain by reason of such payment regardless of how any such claim or demand may
arise, including all costs or expenses incurred by Kerr-McGee Rocky Mountain Corporation in defending its position in any such claim,suit or action.
The undersigned agrees to notify Kerr-McGee Rocky Mountain Corporation, 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.
Kerr-McGee Rocky Mountain Corporation. 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 Kerr-McGee Rocky Mountain
Corporation any amount attributable to an interest to which the undersigned is not entitled.
Kerr-McGee Rocky Mountain Corporation may accrue proceeds until the total amount equals twenty-five dollars($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 Kerr-McGee Rocky Mountain Corporation may have certain
statutory rights under the laws of the state in which the property is located.
The undersigned authorizes Kerr-McGee Rocky Mountain Corporation to withhold from the proceeds of any and all production referred to herein the
amount of any tax placed thereon by any governmental authority and to pay the same on our behalf.
Wit aztar
Owner(s)Signature(s): V
1rk�'�pB. :rd
Wi�liam_H .Jerke . Chair Pro-Tern /f t •••— -�. z'
(06/02/2004) De�� ,L'"l��_ tg�� ,e Boar
Owner(s)S.S.or Tax I.D.# 84-6000-813 '�J 1861 r; ,
1/49
Owner Daytime Telephone# (970) 356-4000 X4200 ‘r.
Mir
Owner Fax Telephone# (970) 356-0242 ‘•
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Federal Law requires you to furnish your Social Security or KMG USE ONLY
Taxpayer Identification Number. Rec'd by Date:
Failure to comply will result in 31%tax withholding and will ReIS'd by Date:
not be refundable by Payer
Approv'd by Date: Ztre,24"4-
2004-1645
EXHIBIT "A"
HSR-FITZPATRICK #4-20A --"J" SAND DEEPENING
Well No. 920461
TOWNSHIP 3 NORTH - RANGE 66 WEST, Section 20: N'h
320 ACRES, MORE OR LESS
WELD COUNTY, COLORADO
ner/ x•. �& t t 0,").44 +tc4 l PtTi of j¢ i s't k*k,4 4D8cri718I Interest
ilm .Olglier „ ;, 3& '7, . ,,, r ,q1 lnteresacaieu os Interest T-ifP& ,
BEL410 BELLA HOLSTEINS, INC. 62.5/320 ac x 7/8 MI x 12.5% RI 0.02136230 RI
160/320 ac x 39.27456% MI x 12.5%
BEN860 BENSON MINERALS GROUP, INC. RI 0.02454660 RI
BOARD OF CHURCH EXTENSION OF
BOA724 DISCIPLES OF CHRIST 80/320 ac x 1/64 MI x 12.5% RI 0.00048828 RI
160/320 ac x 1.90848% MI x 12.5%
BRE490 KENNETH A. BREITENBACH RI 0.00119280 RI
160/320 ac x 1.90848% MI x 12.5%
BRO960 JAMES D. BROWNLIE RI 0.00119280 RI
BWA100 BWAB INCORPORATED 160/320 ac x 5% MI x 12.5% RI 0.00312500 RI
FLA554 FLANNER HOUSE 80/320 ac x 1.25% MI x 12.5% RI 0.00039063 RI
FLY556 EMILY FLYNN HOME AT MARION INDIANA 80/320 ac x 1/64 MI x 12.5% RI 0.00048829 RI
FRE220 NORMA JEAN FREEDMAN 160/320 ac x 1/2 MI x 0.625% OR 0.00156250 OR
TRUSTEES OF GARDEN CITY CHRISTIAN
GAR223 CHURCH 80/320 ac x 1/64 MI x 12.5% RI 0.00048828 RI
GRA572 LENA MAE GRANT IRREVOCABLE TRUST 160/320 ac x 1/2 MI x 0.10938%OR 0.00027345 OR
HAG250 MARY ANN HAGEN 160/320 ac x 1/4 MI x 12.5% RI 0.01562500 RI
HSR001 KERR-McGEE ROCKY MOUNTAIN CORP. 50/320 ac x 87.5% MI x 5% OR 0.00683594 OR
HSR001 KERR-McGEE ROCKY MOUNTAIN CORP. 100% GWI 0.86191406 WI
INDIANAPOLIS FOUNDATION CONSOLIDATED
IND413 FUND 2835003610 80/320 ac x 3.75% MI x 12.5% RI 0.00117187 RI
KENT K. KRAMER AND RHONDA S. KRAMER,
KRA520 JOINT TENANTS 2/320 ac x 7/8 MI x 12.5% RI 0.00068359 RI
NAT483 CATCHING THE DREAM 80/320 ac x 1/64 MI x 12.5% RI 0.00048828 RI
NOR730 NORTH AMERICAN RESOURCES COMPANY 160/320 ac x 1/2 MI x 0.0625% OR 0.00015625 OR
(2.42/320 ac x 58.3333% MI x 12/5%
RI) + (11.76/320 ac x 7/8 MI x 12.5%
OLI670 RAY E. OLIN AND SHIRLEY A. OLIN, JT RI) 0.00457096 RI
PAT735 MARGARET L. PATTERSON 160/320 ac x 1/4 MI x 12.5% RI 0.01562500 RI
PIR940 ROBERT S. PIRTLE 160/320 ac x 1/2 MI x 0.125% OR 0.00031250 OR
PIR946 WILLIAM PIRTLE 160/320 ac x 1/2 MI x 0.125% OR 0.00031250 OR
ROG270 MARTIN L. ROGERS 160/320 ac x 1/2 MI x 0.07817% OR 0.00017968 OR
SAL818 THE SALVATION ARMY 80/320 ac x 1.25% MI x 12.5% RI 0.00039062 RI
(2.42/320 ac x 29.1667% MI x 12/5%
RI) + (1.32/320 ac x 7/8 MI x 12.5%
SCH654 DEBORAH A. SCHONEMAN RI) 0.00072689 RI
SMI807 CHARLOTTE SMITH 160/320 ac x 1/2 MI x 0.13125% OR 0.00032813 OR
TIA360 TIAGO CORPORATION 160/320 ac x 1/2 MI x 1.25% OR 0.00312500 OR
160/320 ac x 1.90848% MI x 12.5%
WAL405 JOHN R. WALLACE RI 0.00119280 RI
WEL210 WELD COUNTY BOARD OF COMMISSIONERS 80/320 ac x 12.5% RI 0.03125000 RI
TOTAL: 1.00000000
Page 1 of 1 5/12/2004
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 escription, and
percentage of royalties, if applicable.
BY: —J
- A
Cou . Attorney
DATE: C I 'DC? ) '
KERR AMCGEED ENVER,COLORADO
ROCKY MOUNTAIN CORPORATION
1999 BROADY,SUITE 3600•May 12, 2004
PHONE:303-296-3600
FAX'303-296-3601
RE: HSR-Fitzpatrick#4-20A
Township 3 North, Range 66 West, Section 20: N%:
Weld County, Colorado
Dear Interest Owner:
The subject well was recently deepened to the J Sand formation, which is spaced on an 320-acre
unit. The enclosed Division Order reflects your interest in the new formation; your interest in
the existing formation(s) will not change.
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
furnished.
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 me. The copy
is for your records. Should you have any questions or concerns, feel free to contact me.
Sincerely,
Erin J. Langdon
Division Order Analyst
enclosure
1-E-0--,26(.-'
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