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Home My WebLink About990995.tiff CORRECTION OIL AND GAS DIVISION ORDER OPERATOR: HS RESOURCES, INC. Date: April 28, 1999 1999 BROADWAY, SUITE 3600 DENVER,CO 80202 Well Number: 840020 (303)296-3600 n 06-12_3- Well Name: WAys? Apt I� Lola p O Description: TOWNSHIP 5 NORTH, RANGE 66 WEST SECTION 25: S/2NE/4 County and State: WELD COUNTY,COLORADO Owner: Decimal Interest: Type: Weld County Colorado .00367190 RI c/o Board of County Commissioners P.O. Box 758 Greeley,CO 80632-0758 The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by HS RESOURCES,INC. The undersigned agrees to notify HS RESOURCES, INC., 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. HS RESOURCES, INC. 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 HS RESOURCES, INC.any amount attributable to an interest to which the undersigned is not entitled. HS RESOURCES, INC.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 HS RESOURCES,INC.may have certain statutory rights under the laws of the state in which the property is located. The undersigned authorizes HS RESOURCES, INC.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. Wt ss/^ttj, Owner(s)Signature(s): �►�q� r, L:�. S ��% rt Dale K. Hall, Chair (05/05/99) I'�i 71 Address: 915 10th Street ' �i / -.t >�i q Deputy Clerk to ',~'- `si". Greeley, CO 80632 (- t Owner(s)Tax ID#/ 84-6000-813 (t r:: O Social Security Number l\V Owner Daytime Telephone# (970)356-4000 X4200 kJLI' UILIMJ ! 1J!!°LJ!'!0 !!' J" "ner Fax # 2 1 of 1 R 0.00 D 0.00 JA Suki Tsukamoto 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. CORREt. LION OIL AND GAS DIVISION ORDER OPERATOR: HS RESOURCES, INC. Date: April 28, 1999 1999 BROADWAY, SUITE 3600 DENVER, CO 80202 Well Number: 830010 (303) 296-3600 Ape 05- 13--- 1097(0 Well Name: WASS #1 Description: TOWNSHIPLNORTH, RANGE 66 WEST SECTION 25: N/2NE/4 County and State: WELD COUNTY, COLORADO Owner: Decimal Interest : Type: Weld County Colorado .00798440 RI do Board of County Commissioners P. O. Box 758 Greeley, CO 80632-0758 The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by HS RESOURCES, INC. The undersigned agrees to notify HS RESOURCES, INC., 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. HS RESOURCES, INC. 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 HS RESOURCES, INC. any amount attributable to an interest to which the undersigned is not entitled. HS RESOURCES, INC. 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 HS RESOURCES, INC. may have certain statutory rights under the laws of the state in which the property is located. The undersigned authorizes HS RESOURCES, INC. 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. _ (J(J� w ssi 4 i • Owner(s) Signature(s): ►uL a'i t rl,�.i�i�/`/' Dale K . Hall , Chair 05 /05 / 99 ) _til I I %f . Address: 915 10th Street Deputy Clerk to Greeley , CO 80632 N > " �S tB Owner(s) Tax ID # / 84- 6000-811 Social Security Number ) ) Owner Daytime Telephone # ( 970,1156-4000 X4700 I IIIIII IIIII IIIIII IIII IIIII IIIIII IIIIII III "III IIII IIII Owner Fax Telephone # ( 970) 352-0242 2693361 05/12/1999 12 : 05P Weld County CO 1 of 1 R 0 . 00 D 0 . 00 JA Sukl Tsukamoto Federal Law requires you to furnish your Social Security or Taxpayer Identification Number. ♦ r} f CFailulre to comply will result in 31% tax withholding and will not be refundable by Payor. ?DR?.. )R li . ':e }/ 7 C;,, .,T.i. HS RESOURCES, INC. 1999 BROADWAY, SUITE 3600 DENVER, COLORADO 80202 -- -)5 (303) 296-3600 FACSIMILE (303) 296-3601CLE April 28, 1999 Weld County Colorado c/o Board of County Commissioners P. O. Box 758 Greeley, CO 80632-0758 RE: Wass #1, Wass #2 Township 5 North, Range 66 West Section 25: N/2NE/4, S/2NE/4 Weld County, Colorado HS Resources, Inc. operates the referenced wells located in Weld County, Colorado. When doing some recent updates we determined that your interest for the Wass #1 and Wass #2 were not updated at the time when the Wass #3X and Wass #6 were completed. The interest should be the same for the Wass #1 and#3X and for the Wass #2 and#6. Enclosed please find Division Orders to reflect these changes. Please review the Division Orders and if they meet with your approval, execute them, have your signature witnessed by two individuals, include your Tax Id Number and return the originals to our office. The Division Orders marked "COPY" are for your records. We have updated our records to reflect this change. Your account will remain in a pay status. Please contact our office if you have any questions. Thank you for your attention to this matter. Sincerely, HS RESOURCES, I C. qq MARY K. ALSEY Divisio der M1 mkh Enclosures 990995 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. i i BY: �� ( ounty/Attorney m-- DATE: 1-1- f sr Hello