HomeMy WebLinkAbout20013475.tiff OIL AND GAS DIVISION ORDER
OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: November 20,2001
1999 BROADWAY,SUITE 3600 Effective Date: Date of First Production
DENVER,CO 80202 Well Number; , 9214534. c,
(303)296-3600
Well Name: HSR-FINE#3-20A
Description: T3N-R66W,SEC.20: NY2
Formation: J Sand
County and State: Weld County,Colorado
Owner: Address: Decimal Interest:
WEL210 915 Tenth Street 0.03125000 RI
WELD COUNTY BOARD OF Greeley,CO 80632
COMMISSIONERS
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. 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.
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Owner(s)Signature(s): j �L ... ;
186
M. J. Geile, Chair (12/10/01) . �� }
Deputy Clerk t
Owner(s)S.S. or Tax I.D.# 84-6000-813 ® ?;. • ,-,1
f.ifft I'
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 Payor.
Lb OU'7 '
2001-3475
EXHIBIT "A"
HSR-FINE #3-20A -- "J"SAND DEEPENING
Well No. 920531
TOWNSHIP 3 NORTH - RANGE 66 WEST, Section 20: N'/
320 ACRES, MORE OR LESS
WELD COUNTY, COLORADO
13278 Weld County Road 32
BEL410 BELLA HOLSTEINS, INC. Platteville, CO 80651 0.02136230 RI
Department 161
BEN860 BENSON MINERALS GROUP, INC. Denver, CO 80271 0.02454660 RI
BOARD OF CHURCH EXTENSION OF P.O. Box 7030
BOA724 DISCIPLES OF CHRIST Indianapolis, IN 46207 0.00048828 RI
410 17th Street, Suite 1151
BRE490 KENNETH A. BREITENBACH Denver, CO 80202 0.00119280 RI
475 17th Street, Suite 980
BRO960 JAMES D. BROWNLIE Denver, CO 80202 0.00119280 RI
475 17th Street, Suite 1390
BWA100 BWAB INCORPORATED Denver, CO 80202 0.00312500 RI
2424 Martin Luther King Jr. Drive
FLA554 FLANNER HOUSE Indianapolis, IN 46208 0.00039063 RI
Bank of Oklahoma,Agent
P.O. Box 1588
FLY556 EMILY FLYNN HOME AT MARION INDIANA Tulsa, OK 74101 0.00048829 RI
TRUSTEES OF GARDEN CITY CHRISTIAN 5201 Rockville Road
GAR223 CHURCH Indianapolis, IN 46224 0.00048828 RI
734 Oregon
HAG250 MARY ANN HAGEN Gooding, ID 83330-1450 0.01562500 RI
Bank One Trust Company, N.A.
INDIANAPOLIS FOUNDATION CONSOLIDATED P.O. Box 2605
IND413 FUND 2835003610 Ft. Worth, TX 76113-2605 0.00117187 RI
KENT K. KRAMER AND RHONDA S. KRAMER, 1407 Dexter St.
KRA520 JOINT TENANTS Broomfield, CO 80020 0.00068359 RI
do Dean Chavers
8200 Mountain Road NE, Suite 203
NAT483 CATCHING THE DREAM Albuquerque, NM 87110-7835 0.00048828 RI
13478 Weld County Road 32
OLI670 RAY E. OLIN AND SHIRLEY A. OLIN* Platteville, CO 80651 0.00457096 RI
505 Sherri Drive
PAT735 MARGARET L. PATTERSON Loveland, CO 80537-7254 0.01562500 RI
3100 N. Meridian Street
SAL818 THE SALVATION ARMY Indianapolis, IN 46208 0.00039062 RI
13452 WCR 32
SCH654 DEBORAH A. SCHONEMAN Platteville, CO 80651 0.00072689 RI
475 17th Street, Suite 980
WAL405 JOHN R. WALLACE Denver, CO 80202 0.00119280 RI
915 Tenth Street
WEL210 WELD COUNTY BOARD OF COMMISSIONERS Greeley, CO 80632 0.03125000 RI
1580 Lincoln Street, Suite 650
FRE220 NORMA JEAN FREEDMAN Denver, CO 80203 0.00156250 OR
Page 1 of 2 11/20/01
EXHIBIT "A"
HSR-FINE #3-20A --"J"SAND DEEPENING
Well No. 920531
TOWNSHIP 3 NORTH - RANGE 66 WEST, Section 20: NY:
320 ACRES, MORE OR LESS
WELD COUNTY, COLORADO
s fitiiP sl a4� {
Errol J. McBride, Trustee
Route 4, Box 8
GRA572 LENA MAE GRANT IRREVOCABLE TRUST Crawfordsville, IN 47933 0.00027345 OR
4222 Jennie Avenue
HIX000 BILLYE L. HIX Amarillo, TX 79106-6031 0.00032813 OR
1999 Broadway, Suite 3600
HSR001 HS RESOURCES, INC. Denver, CO 80202 0.00683594 OR
600 S. Excelsior
NOR730 NORTH AMERICAN RESOURCES COMPANY Butte, MT 59701 0.00015625 OR
Box 1310
PIR940 ROBERT S. PIRTLE Tyler, TX 75710 0.00031250 OR
403 Brighton Court
PIR946 WILLIAM PIRTLE Tyler, TX 75701 0.00031250 OR
3737 14th Street SE
ROG270 MARTIN L. ROGERS Loveland, CO 80537 0.00017968 OR
P.O. Box 370053
TIA360 TIAGO CORPORATION Denver, CO 80237 0.00312500 OR
1999 Broadway, Suite 3600
HSR001 KERR-McGEE ROCKY MOUNTAIN CORP. Denver, CO 80202 0.86191406 WI
TOTAL: 1.00000000
* Payment designation only. Mineral interest owned by OLI501 -the Olin Family Limited Partnership, LLLC
Tract 1: WY,NW%(80 ac.)
Tract 2: A tract in NE%NW%containing 2 ac.
Tract 3: The West 550'in the North 3/4 of NE%NW%,containing 12.5 ac.
Tract 4: A tract in the NE%NWY.containing 2.42 ac.
Tract 5: Lot A of Recorded Exemption No. 1211-2-03-RE2004,being a tract in the NE%NW%,containing 1.32 ac.
Tract 6: Lot B of Recorded Exemption No. 1211-2-03-RE2004,bing a tract in the NE%NW%,containing 11.76 ac.
Tract 7: The SE%NW%and the South 10 acrea of NE%NW%,containing 50 ac.
Tract 8: NE%(160 ac.)
Page 2 of 2 11/20/01
CI KERR-MCGEE ROCKY MOUNTAIN CORPORATION
1999 BROADWAY•SURE 3800•DENVER,COLORADO 80202
PHONE 303/198.3800
FAX:303/1963801
INSTRUCTIONS FOR EXECUTION OF OIL AND GAS DIVISION ORDERS
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 us. The
copy is for your records.
Should you have any questions,please do not hesitate to call.
ERIN J. LANGDON
KERR-McGEE ROCKY MOUNTAIN CORPORATION
1999 BROADWAY, SUITE 3600
DENVER, CO 80202
(303) 296-3600, EXT. 488
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-0 to form, legal description, and
percentage of royalties, -applicable.
Couthty Attorney
DATE: / / A /2 (
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