HomeMy WebLinkAbout20001769.tiff KEEP FOR YOUR RECORDS - CUSTOMER COPY
AUTHORIZATION TO RECEIVE OIL AND DIRECTION FOR PAYMENT
TO: EQUIVA TRADING COMPANY ( ETCO ) Lease No. 001564
Division Order Department
Post Office Box 46O4
Houston, Texas 7721O-46O4
Toll Free 1-8OO-992-847O Date: JULY 6, 2000
Effective at 7:00 A.M. MAY 1, 2000 and until the first day of the month following thirty (30) days advance written notice of
change of ownership or termination, you are authorized to receive the production of the undersigned from the following described
lease in accordance with your agreement with the lease operator:
SMITH OIL PROPERTIES INC -- HAAS #1 LEASE
located in WELD County, State of COLORADO
described as:
BEING THE NE/4 NE/4 OF SECTION 15, TOWNSHIP 6 NORTH (T6N) - RANGE 67 WEST (R67W), WELD COUNTY,
COLORADO.
The undersigned warrants to ETCO ownership of the interest indicated below next to their name in the oil produced and save] from the
above lease and directs ETCO to distribute payment for such oil as provided below.
CREDIT TO OWNER NUMBER: 000053723 TYPE: ROYALTY INTEREST: 0.0000781
TRANSFERRED FROM: 999999999
CURRENT INTEREST(S) IN PAY STATUS FOR THIS LEASE:
WELD COUNTY CLERK TO THE BOARD
PO BOX 758
GREELEY CO 80632-0758
CONFIRMATION
MOHlUII H 0 HV I IN m ��I�II�NIaII�MIII�II Iu �I� h II IUIId HI110111 la II I VNI ��NII Ih
In the event, of a dispute concerning title to any portion of the proceeds of this interest, ETCO may hold the proceeds until it receives
evidence of title satisfactory to ETCO. The undersigned agrees to notify E'I'CO in writing of any change in the decimal interest and all
changes shall be effective the first day of the month following ETCO's receipt of such notice. For any claims miring from the undersigned's
failure to provide written notice, the undersigned will fully indemnify and hold ETCO harmless. If action or inaction by the undersigned
causes ETCO to over-pay this interest, then ETCO may recoup the overpaid amount from the undersigned's interests in other leases.
Finally, all payments shall he subject to all 'e- et , uture laws, regulations and orders.
5( I,
SIGNATURE OF OWNER(S) 17
< < • 0,: PAYMENT FOR THIS INTEREST SHOULD BE SE.N'I TO:
� �
NA/ t � �/��� tee, 915 10th Street
Barbara . Ki-,fl'e_y arA
✓ ill
ATTES � � � � �lr�a��41w Greeley, Colorado 80631By:
SOCIA ,
84-6000-813
DAYTIME TELEPHONE NUMBER ( 970 ) 356-4000 CORRESPONDENCE AND IRS FORM 1099 SHOL LI) BE SENT' 'Ii :
El Please check if these are NEW ADDRESSES and apply to all 915 10th Street
leases with this owner number.
RECD Greeley, Colorado 8063 L
N/A
SUSPENSE
os
0 D of I
W •.ANALYST ZIP + 4 CC 2000-1769
ARoi
O1 20000706120203 SMGARCI (".-15°`" `t'°
EQUIVA TRADING COMPANY.
CUSTOMER SERVICE
Office Hours 7:30 A.M. - 5:00 P.M. (CST)
Telephone: 1-800-992-8470 FAX: (713)277-6888
WELD COUNTY CLERK TO THE BOARD
PO BOX 758
GREELEY CO 80632-0758
JULY 6, 2000
Dear Interest Owner,
The enclosed Authorization Document has been prepared on the basis of documentation provided.
Please examine the Authorization Document for accuracy. If you agree 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 are required and should be included in the
spaces provided. The executed original should then be returned to our office.
If the fully executed Authorization is received in our office on or before the end of the month, we
will release payment for prior purchases on the 20th day of the following month, providing that the
accruals to the interest amount to at least $25.00.
Please refer to our lease number and your owner number in any communications with our company
so that we can respond promptly.
FOR YOUR INFORMATION
Payments will be made monthly for oil received during the previous-month unless the amount due is
less than $25.00. Amounts of less than $25.00 will be accumulated and paid when the total cithcr
equals or exceeds $25.00 or at such time during each fiscal year when all amounts due of $5.00 .n
more are released to owners whose accounts are in pay status. Amounts due of less than $5.00, will
be released when requested by owner.
Please send written notice of any name or address change to:
Division Order Department, P.O. Box 4604, Houston, TX 77210-4604
Be sure to indicate your owner and tax identification numbers
001564
000053723 WELD COUNTY R 0 . 0000781
000129763 SMITH JAMES A W 0 . 2082294
000364610 RODDER GERALD R W 0 . 0416459
000383785 LINDBERG ROD O 0 . 0200000
000384564 TRISTAR ENERGY GROUP W 0 . 1665835
000384566 LIEBIG ANN M W 0 . 2082294
000384570 NORMAN MELISSA W 0 . 0416458
000384573 TREY PARTNERS W 0 . 1665835
000384607 WILLIA ET AL MYRON B ANDERSON R 0 . 0022838
000384608 PARAGO ANDREW L & BECKY A 0 0 . 1236941
000384608 PARAGO ANDREW L & BECKY A R 0 . 0025737
000384609 GREAT WESTERN RAILWAY CO R 0 . 0076232
000384610 HUWA RICHARD & VALERIE R 0 . 0051475
000384611 RIDER MORRIS E & NORMA J R 0 . 0019937
000384612 RODRIGUEZ KIM R 0 . 0016947
000384614 SCOTT DONALD H & MARY SUE R 0 . 0019937
PAGE 1
COUNTY ATTORNEY STAFF APPROVAL
This is to affirm the attached Division Order and Authorization to
Receive Payment for an Oil and Gas Well Fjas been reviewed by
the County Attorney's staff as to form, dal d scription, and
percentage of regalia, if applicable..
/ >
BY:
� � �7 .!r� -
County Attorne'y'
DATE 112 I
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