HomeMy WebLinkAbout20001201.tiff OIL AND GAS DIVISION ORDER CM
Date: April 14, 2000
•
Lease No.: 114351011
Lease Name: Bickling 31 -22 (CDL)
Effective Date: 4/1 /00
RP) 05- a 3 -- / 165@
To: Patina Oil & Gas Corporation
1625 Broadway, Suite 2000
Denver, CO 80202
Each of the undersigned, individually, for themselves, their heirs, successors, and assigns, hereby
represents, warrants, and guarantees to Patina Oil & Gas Corporation (hereinafter referred to as the
"Company") , its successors and assigns, that the undersigned is the legal owner of the decimal interest, as set
forth below opposite each undersigned 's name, in the proceeds from all oil, condensates, and natural gas
which may be produced from or allocated to the following-described area or well located in the County of
Weld, State of Colorado, and more particularly described as follows:
Township 6 North, Range 65 West, 6t" P.M.
Section 22: NE/4
Commencing on the effective date hereof, the Company is hereby granted and authorized to take and
receive all oil, condensates, and natural gas which may be thereafter produced from the above-described area
or well and, subject to the other terms and conditions hereof, to give credit therefor to the undersigned in
accordance with the division of interest schedule as follows:
Credit To Address Decimal Interest
See Exhibit "A" attached
Additionally, in consideration of the wells drilled or to be drilled on the above-described lands and the
payment to the undersigned of royalties on production from said wells, the undersigned agree, grant, and
represent to and with the Company as follows:
1 . Oil (including crude oil and condensate) shall become the property of the purchaser thereof
upon its delivery to the purchaser or to the purchaser's agent or carrier, and payments hereunder shall be based
upon the net price received therefor from the purchaser. Oil shall be graded and measured in accordance with
applicable rules, regulations, or standards generally accepted in the industry. In the event that the Company is
the purchaser of such oil, settlements therefor shall be based upon the Company's posted price for similar oil in
the field where produced and in effect on the date of delivery, or if no posted price is then in effect,
settlements shall be based upon the then prevailing market price on the date of delivery thereof in the field
where produced . If the oil is purchased by the Company and resold to another purchaser accepting delivery
thereof on the premises, settlements hereunder shall be based on the net price received therefor by the
Company. The Company may deduct from any price received for the oil the reasonable costs of transporting
and/or treating the same if incurred.
2. Natural gas, including casinghead gas if marketed with gas well gas, shall be delivered and
sold to and become the property of the pipeline company to whom the gas IS agreed to be sold by the
Company. Settlements to the undersigned shall be based upon the terms, conditions. and prkces for said gas as
agreed to with the pipeline company and/or gas purchaser less post production costs from.the wellhead to the
point of sale, including but not limited to gathering, compression, transportation, dehydration and transmission.
3 . Oil and natural gas produced and sold from the premises is or may become subject to orders
of certain regulatory authorities who could vary the terms of any agreement for the production or sale thereof .
To the extent that such orders do modify or change current sales or production arrangements, the provisions
thereof, as well as the provisions hereof, shall be so modified accordingly.
4. Settlements hereunder for oil and gas shall be made monthly by the Company mailing or
delivering their check to the undersigned at the address indicated in an amount, less taxes required to be
withheld, calculated in accordance with the schedule of interest as herein contained. Settlements shall be
mailed no later than the 25th day of each month for oil and/or gas taken or sold during the second preceding
calendar month. If at any settlement date the amount payable to any of the undersigned shall be less than
Twenty-five Dollars ( S25) , the Company may defer such payment and make payment when such settlement
amount has accumulated to Twenty-five Dollars ( 825) but, in any event, not less than annual intervals .
5 . The undersigned individually warrant that they are the owner of their respective interest as
herein set forth and that in the event of an adverse claim made thereto or in the event ownership of the
undersigned' s interest is not substantiated by record examination, the Company may retain any and all
settlements due therefor, without interest, until such claim or ownership of the interest is settled, fully
adjudicated or otherwise determined, or until the Company is adequately indemnified therefor by the parties
claiming such interest. The Company may, at any time, require the undersigned to furnish proof of its title to
its interest, including abstracts of title or other pertinent records or documents.
2000-1201
L /-ri e.
6. The undersigned shall notify the Company of any change in the ownership of their interest,
and the Company shall not be liable for, nor shall it be required to recognize, any change in ownership unless
and until the Company shall actually receive a certified copy of the instrument changing such interest and the
transferee thereof executes and returns to the Company such transfer order or amended division order as the
Company may reasonably require. In no event shall the Company be required to give effect to any change of
interest of the undersigned prior to the first day of the calendar month next following the month in which the
Company is notified of such change, regardless of the effective date of the instrument transferring the same.
7. The undersigned hereby represent, grant to, and agree with the Company that the interest of
the undersigned and of the Company in and to the oil and gas which has or which may be produced from the
premises is in full force and effect and that all payments required to be made and all acts required to be done
by the Company with respect thereto have been performed. The undersigned hereby releases the Company
from any and all claims and damages arising from the purchase and handling of oil or gas from the premises
and for making any payments for settlements so long as the same are made in accordance with the terms of
the division of interest schedule set forth on Exhibit "A".
8. In the event that the area or well described above, or any part thereof, is included in one of
more pooled or unitized units now or hereafter formed by order of any appropriate governmental authority by
agreement or otherwise, the undersigned and the Company recognize and agree that settlement for oil and gas
shall be made in accordance with the production allocated to the premises above described without the
necessity for the execution of additional or supplemental division orders. To the extent that the premises as
described above constitute a previously pooled or unitized area, the same is hereby ratified. The undersigned
hereby expressly ratify and confirm the oil, gas and mineral lease or leases, pursuant to which oil and gas from.
the property is being produced and sold, any amendments and supplements to such lease or leases including
any designations, declarations or agreements creating the unit including the above described property, if sucl.
be the case.
9. The provisions hereof shall be binding upon and inure to the benefit of the Company and the
undersigned, their respective heirs, successors, administrators, and assigns. No change in the ownership or
any interest herein described shall have the effect of changing the binding nature hereof. This instrument may
be executed in counterparts with each counterpart considered to be a binding agreement of the signatories
thereto; and all counterparts, as executed, shall be considered to be one instrument.
10. Should it be determined from time to time by the courts, any governmental agency having
jurisdiction, or the Company and the purchaser of production, that the prices or allowances, if any, being paid
to the Company and the amounts being disbursed to the undersigned are in excess of lawful prices or prices
agreed to with the oil or gas purchaser, and a refund is then required, you agree to promptly refund such
excess amounts so paid to you, including interest thereon, if required. Additionally, the Company shall have
the right to recover such excess amounts out of future settlements hereunder to which you are entitled.
11. This division order may be executed in counterparts and shall be binding on and shall inure to
the benefit of each signer hereto, his/her heirs, successors and assigns, whether or not it is executed by all
parties named herein.
WHEREFORE, the undersigned have executed this Division Order in acknowledgment and consent to
the foregoing terms, warranties, and agreements.
Witness - -
Sign Below: $ E t Owner Sign Below: SS No. or Tax ID No.
•
l I�� 1�. .•�� o [ :... 51L 84-6000-813
RI� 0 Chair, Barbar J. KrAmeyer
' er t., t B. . _ _
Deputy Cler C.4
the Board l C ,` \ 4/2000
IMPORTANT: TO AVOID DELAY IN PAYMENT, YOUR CURRENT ADDRESS AND SOCIAL SECURITY
NUMBER OR TAX ACCOUNT NUMBER MUST BE SHOWN
EXHIBIT 'A'
114351011 - BICKLING 31-22 (COL)
OIL AND/OR GAS DIVISION ORDER
DECIMAL INTEREST PAY
Name 8 Address . OWNER NO . INTEREST.. . TYPE .. . CODE
PATINA OIL 8 GAS CORPORATION 20 0.76514680 WI X
1625 BROADWAY, SUITE 2000
DENVER, CO 80202 4
FLORENCE F. BICKLING 289764 0.02042200 RI M
21308 WELD COUNTY ROAD 64
GREELEY, CO 80631
NEW CACHE LA POUDRE IRRIGATION 292251 0.00127270 RI M
CACHE LA POUDRE RESERVOIR CO
P.G. BOX 104
LUCERNE, CO 80646
J. CLEO THOMPSON 8 301564 0.03997350 WI M
JAMES C.THOMPSON JR., A PRTSHP
325 NORTH ST PAUL, 04300
DALLAS, TX 75201.3993
WELD COUNTY COLORADO 305223 0.00119530 RI M
BOARD OF COUNTY COMMISSIONERS
P.O. BOX 758
GREELEY, CO 80632
THEODORE D. SHELDON 311433 0.01812120 OR M
4310 S. LAFAYETTE STREET
ENGLEWOOD, CO 80110
HS RESOURCES, INC. 311840 0.00392110 OR M
1999 BROADWAY STE 3600
DENVER, CO 80202
C01LTON LIMITED LIABILITY CO 380381 0.00565280 WI M
621-17th STREET, STE. 1320
DENVER, CO 80293
ROBERT L ARMANTROUT 702187 0.00442820 OR M
1068 VISALIA DR
COSTA MESA, CA 92626-2117
SHARON F HEINZ 702387 0.00127640 RI SU
7760 KIMBERLY
COMMERCE CITY, CO 80022
JANICE LOUISE WOJCIAK 703074 0.01531650 RI M
P O BOX 423
MOODY, ME 04054
CHRIS CHRISTENSEN JR 704790 0.00326750 OR M
DENVER CLUB BLDG
518 17TH ST SUITE 444
DENVER, CO 80202
FRANK WILSON III 704834 0.01695840 WI M
1250 N E LOOP 410
SUITE 300
SAN ANTONIO, TX 78209-1533
HARLAN R STOFFREGEN 705585 0.01531650 RI M
1663 MENDOCINO LANE
NEWBURY PARK, CA 91320
HERBERT C BICKLING ESTATE 706031 0.00510550 RI SU
205 OAKWOOD RD
WILMINGTON, DE 19803
MARY F KOENEMAN ESTATE 706032 0.01021100 RI SU
C/O CHARLES F KOENEMAN
1511 GLENALLEN AVE
WHEATON, MD 20902
LXIIIBII 'A'
114351011 - BICKLING 31-22 (CDL)
OIL AND/OR GAS DIVISION ORDER
DECIMAL INTEREST PAY
Name & Address . OWNER NO . INTEREST.. . TYPE .. . CIODE
JAMES SPENCER BICKLING 706057 0.00127640 RI SU
7206 W 12TH STREET
GREELEY, CO 80631
JOHN DANIEL BICKLING 706084 0.00127640 RI SU
P 0 BOX 187
AULT, CO 80610
MARGARET RUTH BICKLING 706125 0.00510550 RI SU
2830 27TH ST
APT I) - 103
GREELEY, CO 80632
MELVIN T BICKLING AND 706159 0.05105500 RI M
IMOGENE M BICKLING J/T
21586 HWY 392
GREELEY, CO 80631
JOHN G BRANT TRUSTEE 706434 0.00241830 OR M
DOUSSARD BRANT HODEL&
MARKMAN PROFIT SHARING TRUST
710 KIPLING STREET, SUITE 305
LAKEWOOD, CO 80215
SUSAN BICKLING OMIOR 709088 0.00510550 RI SU
926 1/2 NORTH ORANGE ST
MEDIA, PA 19063
MARIAN J BAKKEN 4 712761 0.00326750 OR M
4635 W. 32ND AVENUE
DENVER, CO 80212
BECKY JANE HAMILTON CLERKIN 713951 0.00127630 RI SU
3750 24TH STREET, APT 7-204
GREELEY, CO 80634
PATCHEN FAMILY PARTNERS, LTD. 714654 0.00163370 OR M
1124 EVENSTAR COURT
FT COLLINS, CO 80526
25 records listed
OIL AND GAS DIVISION ORDER CM
•Date: April 14, 2000
Lease No.: 113861012
Lease Name: Bick E 22-01 (CN)
Effective Date: 4/1/00
To: Patina Oil & Gas Corporation
1625 Broadway, Suite 2000
Denver, CO 80202
Each of the undersigned, individually, for themselves, their heirs, successors, and assigns, hereby
represents, warrants, and guarantees to Patina Oil & Gas Corporation (hereinafter referred to as the
"Company"), its successors and assigns, that the undersigned is the legal owner of the decimal interest, as set
forth below opposite each undersigned's name, in the proceeds from all oil, condensates, and natural gas
which may be produced from or allocated to the following-described area or well located in the County of
Weld State of Colorado, and more particularly described as follows:
Township 6 North, Range 65 West, 6th P.M.
Section 22: NE/4
Commencing on the effective date hereof, the Company is hereby granted and authorized to take and
receive all oil, condensates, and natural gas which may be thereafter produced from the above-described area
or well and, subject to the other terms and conditions hereof, to give credit therefor to the undersigned in
accordance with the division of interest schedule as follows:
Credit To Address Decimal Interest
See Exhibit "A" attached
Additionally, in consideration of the wells drilled or to be drilled on the above-described lands and the
payment to the undersigned of royalties on production from said wells, the undersigned agree, grant, and
represent to and with the Company as follows:
1. Oil (including crude nil and condensate) shall become the property of the purchaser thereof
upon its delivery to the purchaser or to the purchaser's agent or carrier, and payments hereunder shall be based
upon the net price received therefor from the purchaser. Oil shall be graded and measured in accordance with
applicable rules, regulations, or standards generally accepted in the industry. In the event that tie Company is
the purchaser of such oil, settlements therefor shall be based upon the Company's posted price for similar oil in
the field where produced and in effect on the date of delivery, or if no posted price is then in effect,
settlements shall be based upon the then prevailing market price on the date of delivery thereof in the field
where produced. If the oil is purchased by the Company and resold to another purchaser accepting delivery
thereof on the premises, settlements hereunder shall be based on the net price received therefor by the
Company. The Company may deduct from any price received for the oil the reasonable costs of transporting
and/or treating the same if incurred.
2. Natural gas, including casinghead gas if marketed with gas well gas, shall be delivered and
sold to and become the property of the pipeline company to whom the gas is agreed to be sold by the
Company. Settlements to the undersigned shall be based upon the terms, conditions and prices for said gas as
agreed to with the pipeline company and/or gas purchaser less post production costs from the wellhead to the
point of sale, including but not limited to gathering, compression, transportation, dehydration and transmission.
3. Oil and natural gas produced and sold from the premises is or may become subject to orders
of certain regulatory authorities who could vary the terms of any agreement for the production or sale thereof.
To the extent that such orders do modify or change current sales or production arrangements, the provisions
thereof, as well as the provisions hereof, shall be so modified accordingly.
4. Settlements hereunder for oil and gas shall be made monthly by the Company mailing or
delivering their check to the undersigned at the address indicated in an amount, less taxes required to be
withheld, calculated in accordance with the schedule of interest as herein contained. Settlements shall be
mailed no later than the 25th day of each month for oil and/or gas taken or sold during the second preceding
calendar month. If at any settlement date the amount payable to any of the undersigned shall be less than
Twenty-five Dollars ($25), the Company may defer such payment and make payment when such settlement
amount has accumulated to Twenty-five Dollars ($25) but, in any event, not less than annual intervals.
5. The undersigned individually warrant that they are the owner of their respective interest as
herein set forth and that in the event of an adverse claim made thereto or in the event ownership of the
undersigned's interest is not substantiated by record examination, the Company may retain any and all
settlements due therefor, without interest, until such claim or ownership of the interest is settled, fully
adjudicated or otherwise determined, or until the Company is adequately indemnified therefor by the parties
claiming such interest. The Company may, at any time, require the undersigned to furnish proof of its title to
its interest, including abstracts of title or other pertinent records or documents.
6. The undersigned shall notify the Company of any change in the ownership of their interest,
and the Company shall not be liable for, nor shall it be required to recognize, any change in ownership unless
and until the Company shall actually receive a certified copy of the instrument changing such interest and the
transferee thereof executes and returns to the Company such transfer order or amended division order as the
Company may reasonably require. In no event shall the Company be required to give effect to any change of
interest of the undersigned prior to the first day of the calendar month next following the month in which the
Company is notified of such change, regardless of the effective date of the instrument transferring the same.
7. The undersigned hereby represent, grant to, and agree with the Company that the interest of
the undersigned and of the Company in and to the oil and gas which has or which may be produced from the
premises is in full force and effect and that all payments required to be made and all acts required to be done
by the Company with respect thereto have been performed. The undersigned hereby releases the Company
from any and all claims and damages arising from the purchase and handling of oil or gas from the premises
and for making any payments for settlements so long as the same are made in accordance with the terms or
the division of interest schedule set forth on Exhibit "A".
8. In the event that the area or well described above, or any part thereof, is included in one o'
more pooled or unitized units now or hereafter formed by order of any appropriate governmental authority by
agreement or otherwise, the undersigned and the Company recognize and agree that settlement for oil and gas
shall be made in accordance with the production allocated to the premises above described without the
necessity for the execution of additional or supplemental division orders. To the extent that the premises as
described above constitute a previously pooled or unitized area, the same is hereby ratified. The undersigned
hereby expressly ratify and confirm the oil, gas and mineral lease or leases, pursuant to which oil and gas from
the property is being produced and sold, any amendments and supplements to such lease or leases including
any designations, declarations or agreements creating the unit including the above described property, if sucl,
be the case.
9. The provisions hereof shall be binding upon and inure to the benefit of the Company and the
undersigned, their respective heirs, successors, administrators, and assigns. No change in the ownership of
any interest herein described shall have the effect of changing the binding nature hereof. This instrument may
be executed in counterparts with each counterpart considered to be a binding agreement of the signatories
thereto; and all counterparts, as executed, shall be considered to be one instrument.
10. Should it be determined from time to time by the courts, any governmental agency having
jurisdiction, or the Company and the purchaser of production, that the prices or allowances, it any, being paid
to the Company and the amounts being disbursed to the undersigned are in excess of lawful prices or price:,
agreed to with the oil or gas purchaser, and a refund is then required, you agree to promptly refund such
excess amounts so paid to you, including interest thereon, if required. Additionally, the Company shall have
the right to recover such excess amounts out of future settlements hereunder to which you are entitled.
11. This division order may be executed in counterparts and shall be binding on and shall inure to
the benefit of each signer hereto, his/her heirs, successors and assigns, whether or not it is executed by all
parties named herein.
WHEREFORE, the undersigned have executed this Division Order in acknowledgment and consent to
the foregoing terms, warranties, and agreements.
Witness
Sign Below: �qL✓� "i Owner Sign Below: SS No. or Tax ID No.
•
�, 'a_ S4-6000-813_
cC],erk t. c.` - 'i ' r <` J / Chair, Barba t;a J. irkmeyer
Deputy Cler ' l\.i
the Board -Bate: 04/24/7000
IMPORTANT: TO AVOID DELAY IN PAYMENT, YOUR CURRENT ADDRESS AND SOCIAL SECURITY
NUMBER OR TAX ACCOUNT NUMBER MUST BE SHOWN
113861012 - RICK E 22-01 (CN)
011 AND/OR GAS DIVISION ORDER
DECIMAL INTEREST PAY
Name & Address . OWNER NO . INTEREST.. . TYPE .. . CODE
PATINA OIL & GAS CORPORATION 20 0.76255120 WI X
1625 BROADWAY, SUITE 2000
DENVER, CO 80202
FLORENCE F. BICKLING 289764 0.02042200 RI M
21308 WELD COUNTY ROAD 64
GREELEY, CO 80631
NEW CACHE LA POUDRE IRRIGATION 292251 0.00127270 RI M
CACHE LA POUDRE RESERVOIR CO
P.O. BOX 104
LUCERNE, CO 80646
J. CLEO THOMPSON & 301564 0.04255470 WI M
JAMES C.THOMPSON JR., A PRTSHP
325 NORTH ST PAUL., #4300
DALLAS, TX 75201-3993
WELD COUNTY COLORADO 305223 0.00119530 RI M
BOARD OF COUNTY COMMISSIONERS
P.O. BOX 758
GREELEY, CO 80632
THEODORE D. SHELI%N 311433 0.01812110 OR M
4310 S. LAFAYETTE STREET
ENGLEWOOD, CO 80110
HS RESOURCES, INC. 311840 0.00392100 OR M
1999 BROADWAY STE 3600
DENVER, CO 80202
COLTON LIMITED LIABILITY CO 380381 0.00565640 WI M
621-17th STREET, STE. 1320
DENVER, CO 80293
ROBERT L ARMANTROUT 702187 0.00442830 OR M
1068 VISALIA DR
COSTA MESA, CA 92626-2117
SHARON F HEINZ 702387 0.00255280 RI SU
7760 KIMBERLY
COMMERCE CITY, CO 80022
JANIICE LOUISE WOJCIAK 703074 0.01531650 RI M
P 0 BOX 423
MOODY, ME 04054
CHRIS CHRISTENSEN JR 704790 0.00326750 OR M
DENVER CLUB BLDG
518 17TH SI SUITE 444
DENVER, CO 80202
FRANK WILSON I11 704834 0.01696910 WI M
1250 N E LOOP 410
SUITE 300
SAN ANTONIO, TX 78209-1533
HARLAN R STOFFREGEN 705585 0.01531650 RI M
1663 MENDOCINO LANE
NEWBURY PARK, CA 91320
JOHN DANIEL BICKLING 706084 0.00255280 RI SU
P O BOX 187
AULT, CO 80610
MARGARET RUTH BICKLING 706125 0.01021100 RI SU
2830 27TH ST
APT D - 103
GREELEY, CD 80632
EXHIBIT 'A'
113861012 - BICK E 22-01 (CN)
OIL AND/OR GAS DIVISION ORDER
DECIMAL INTEREST PAY
Name & Address . OWNER NO . INTEREST.. . TYPE .. . CODE
MELVIN T BICKLING AND 706159 0.02042200 RI M
IMOGENE M BICKLING J/T
21586 HWY 392
GREELEY, CO 80631
JOHN G BRANT TRUSTEE 706434 0.00241830 OR M
DOUSSARO BRANT HODEL&
MARKMAN PROFIT SNARING TRUST
710 KIPLING STREET, SUITE 305
LAKEWDOD, CO 80215
CHARLES F KOENEMAN 709087 0.02042200 RI SU
1511 GLENALLAN AVE
WHEATLAND, MD 20902
MARIAN J BAKKEN 712761 0.00326750 OR M
4635 W. 32ND AVENUE
DENVER, CO 80212
BECKY JANE HAMILTON CLERKIN 713951 0.00255270 RI SU
3750 24TH STREET, APT 7-204
GREELEY, CO 80634
JAMES SPENCER BICKLING AND 713952 0.00255280 RI SU
SHALA BICKLING
P.O. BOX 353
EDWARDS, CO 81632
SUSAN BICKLING OMLOR AND 713953 0.01021100 RI SU
WALTER R. OMLOR JR. H&W
926-1/2 N. ORANGE STREET
MEDIA, PA 19063
H. CLARK BICKLING JR. 713954 0.01021100 RI M
2406 FREDERICK AVENUE
WILMINGTON, DE 19805
PATCHEN FAMILY PARTNERS, LTD. 714654 0.00163380 OR M
1124 EVENSTAR COURT
FT COLLINS, CO 80526
25 records listed
PATNA
OIL & GAS CORPORATION
•
1625 Broadway Suite 2000
Denver, Colorado 80202
(303) 389-3600
(303) 389-3680 Fax
Dear Interest Owner:
Please read carefully before signing the enclosed oil and gas division orders:
1. Your interest as shown on this instrument should not be altered ot,:tny way unless accompanied by docu-
mentary evidence to support the change. We may reject any division orders changed without our ap-
proval. Do not detach Exhibit "A", if applicable.
2. Furnish in writing any change of address information and include your signature. For change .n owner-
ship, furnish copies of properly filed and recorded legal documents affecting tide of interest ownership
under which payment is made. Provide a letter describing effect of change.
3. Sign your name EXACTLY AS IT APPEARS ON THE INSTRUMENT. Please have your signature
witnessed by two separate parties.
4. If signing for a corporation, signature must be attested. corporate seal affixed and title of signatory party
shown.
5. If signing for a partnership, all partners must sign. unless signed by an authorized partner and we are
furnished a certified copy of his/her authority.
6. If the instrument is signed by an agent, attorney-in-fact, guardian, estate representative, trustee or any
party other than the named interest owner, we must have evidence of the rights vested in the signatory
party.
7. If an interest is shown jointly for more than one person, each party must sign the division order in the
manner that his or her name is shown thereon. In the event one party has been designated agent for the
joint interest shown or he/she has been granted a power of attorney for the other party(ies), we must have
evidence to this effect.
8. Insert your Tax Identification Number or Social Security Number, whichever is applicable, in the space
provided. We may withhold payment until such number is received.
9. Confirm the address to which checks are to be mailed. If different, please provide the correct address.
You should notify us promptly of any changes in your mailing address.
10. The number assigned to this property can be found in the upper right corner of the form. The number
will be used to designate this property on your revenue check. Refer to the property number when corre-
sponding.
11. Return the executed instrument without delay to the address below. KEEP ONE COPY FOR YOUR
RECORDS.
PATINA OIL & GAS CORPORATION
ATTENTION: KAREN MURRAY
1625 BROADWAY, SUITE 2000
DENVER, CO 80202
I,IJ%
oil-a y- oo-o
COUNTY ATTORNEY
STAFF APPROVAL
This is to affirm the attached
Division Order or 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
applicable. ,
BY: ' __-
burlty Att/ney
DATE: }�'--;' — '1 c Th
Hello