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Home My WebLink About20030764.tiff • ulL AND GAS DIVISION ORDLA OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: February 25, 2003 1999 BROADWAY, SUITE 3600 Effective Date: Date of First Production DENVER, CO 80202 Well Number: 621140 (303) 296-3600 Well Name: Damiana Frank GU #1 Description: TIN-R66W, Section 19: W'/: (well located in the SW/4) 7 Formation: J Sand County and State: Weld County- r.^t^...a.. Owner: Address: Decimal Interest: WEL225 PO BOX 758 0.00052908 RI COUNTY OF WELD, STATE OF GREELEY,CO 80632-0758 COLORADO 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. /�� Wi es e.- . � IELA, Owner(s) Signature(s): ' ° f jw — ` J�W� 1Z? • Deputy Clerk t . Owner(s) S.S. or Tax I.D. # 84-6000-813 Owner Daytime Telephone # ( 970 ) 356-4000 X4200 Owner Fax Telephone # ( 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 Paynr 2003-0764 entaad _ t" ,- ,0 /"In / E7O /(D EXHIBIT "A" DAMIANA FRANK GU #1 TOWNSHIP 1 NORTH, RANGE 66 WEST SECTION 19: W/2 (well located in the SW/4) 330.76 ACRES, M/L J SAND FORMATION WELL # 621140 REVISED 03/01/03 OWNER MAILING INTEREST DECIMAL INTEREST NUMBER OWNER NAME ADDRESS CALCULATION INTEREST TYPE RANDALL GENE DAMIANA AND SANDRA DAMIANA, RT 1 BOX 113 A 165.36/330.76 AC X 12.5% DAM414 T/C (Place in"B"suspense) MOORE, ID 83255-9801 RI 0.06249244 RI 12486 WELD CO. ROAD 8 DAV502 THERESA DAVIS FORT LUPTON, CO 80621 51.4/330.76 AC X 12.5%RI 0.01942496 RI 1999 BROADWAY, SUITE 3600 HSR001 KERR-MCGEE ROCKY MOUNTAIN CORPORATION DENVER, CO 80202 0.86723002 WI 1999 BROADWAY, SUITE 3600 HSR001 KERR-MCGEE ROCKY MOUNTAIN CORPORATION DENVER, CO 80202 0.00776998 OR 12236 WCR 8 MCW455 STEVEN S MCWILLIAMS FORT LUPTON,CO 80621 88.2/330.76 AC X 12.5% RI 0.03333233 RI 9885 E 158TH PL. OCK275 WILLIAM AND BARBARA OCKER BRIGHTON,CO 80602 24.4/330.76 AC X 12.5%RI 0.00922119 RI PO BOX 758 WEL225 COUNTY OF WELD, STATE OF COLORADO GREELEY,CO 80632-0758 0.14/330.76 AC X 12.5%RI 0.00052908 RI TOTAL: 1.00000000 Page 1 KERR-McGEE ROCKY MOUNTAIN CORPORATION 1999 BROADWAY SUITE 3600 • DENVER gbruary 25,2003 County of Weld, State of Colorado PO Box 758 Greeley, CO 80632-0758 PHONE: 303-296-3600 RE: Rittenhouse 11-19A(120690) FAX: 303-296-3601 Damiana Frank GU#1 (621140) Damiana Frank GU True#1 (621150) J Sand Formation TIN,R66W, Sec. 19: W/2 Weld County, CO Dear Sirs: The Rittenhouse 11-19A has recently been drilled and completed to the I Sand formation. In setting up this new well we also revised the existing division of interest for the Damiana Frank GU #1 and the Damiinan Frank GU True #1. It is our company policy to obtain a new, signed division order on all new formations and new wells. We are enclosing Division Orders for your signature. We will be changing our records to the revised interests regardless of whether we receive your signed revised Division Order. We will hold your interest in suspense on the new well (Rittenhouse 11-19A) until a signed Division Order is received. 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. If your address is shown incorrectly, please correct it. This is the address we will use for mailing your checks; 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. You may retain the Exhibit"A"for your records as well as the copy of the division order. If you have any questions,please feel free to call me at(303)296-3600,ext.2822. Yours truly, KERR-MCGEE ROCKY MOUNTAIN CORPORATION • Rebecca A.Bell Sr. Division Order Analyst /rab ends. 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 applicab- BY: l �� r_ Coun ttorney DATE: -›71+(<1—S Hello