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HomeMy WebLinkAbout960311.tiff AUTHORIZATION TO RECEIVE OIL AND DIRECTION FOR PAYMENT TO: TEXACO TRADING AND TRANSPORTATION INC. ( TTTI ) Lease No. 053712 Lease Ownership Post Office Box 5568 Denver, Colorado 80217-5568 Toll Free 1-800-992-8470 Ad 24767 Date: FEBRUARY 1, 1996 Effective at 7:00 A.M. DECEMBER 1, 1995 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: WALSH PRODUCTION INC -- LILLI FIELD UNIT GAS TRACT 19 LEASE located .n WELD County, State of COLGRADO described as: TOWNSHIP 8 NORTH - RNAGE 58 WEST SECTION 6: LOTS 12 & 15 FEDERAL LEASE #C-57211 TRACT PARTICIPATION FACTOR - 0.0342310 The undersigned warrants to 1'1'11 ownership of the interest indicated below next to their name in the oil produced and saved from the above lease and directs TTTI to distribute payment for such oil as provided below. CREDIT TO OWNER NUMBER: 000053723 TYPE: ROYALTY INTEREST: 0.0392169 TRANSFERRED FROM: 999999999 CURRENT INTEREST(S) IN PAY STATUS FOR THIS LEASE: WELD COUNTY CLERK TO THE BOARD PO BOX 758 GREELEY CO 80832-0758 • II�II�UII ��I��l�V �IUIUV��IV 111111t I muI 1111 11 In the event of a dispute concerning title to any portion of the proceeds of this interest, TTTI may hold the proceeds until it receives evidence of title satisfactory to TTTI. The undersigned agrees to notify TTTI in writing of any change in the decimal interest and all changes shall be effective the first day of the month following TTTI's receipt of such notice. For any claims arising from the undersigned's failure to rovide written notice, the undersigned will fully indemnify and hold TTTI harmless. If action or inaction by the undersigned coos to over-pay this interest, then 11TI may recoup the overpaid amount from the-undersigned's interests in other leases. ments shall be ubject to all present and future laws, regulations and orders. i E (V PAYMENT FOR THIS INTEREST SHOULD BE SENT TO: CLERK TO THE BOARD OF WELD COUNTY COMMTSSTONERS (861 ({• E HAI PO :BOX 758 :DEPUTY p1 'SEU O AX ID NUMBER 'TOTH THE BOARD GREELEY, CO 80632-0758 ' ter: 84-6000813 DAYTIME TELEPHONE NUMBER ( 970 )356-4000 CORRESPONDENCE AND IRS FORM 1099 SHOULD BE SENT TO: X4225 ❑ Please check if these are NEW ADDRESSES and apply to all AS ABOVE leases with this owner number. RECD Z N/A F SUSPENSE F Dofl ZIP + 4 CODE IS REQUESTED ANALYST 2476739 B-1532 P-612 02/16/96 03:13P PG 1 OF 3 Tear Lcc//9 CONSENT AGENDA Weld County CO Clerk & Recorder 960311 .,tom//cZ/C w „ TEXACO TRADING AND TRANSPORTATION INC. CUSTOMER SERVICE Office Hours 6:30 A.M. - 4:30 P.M. (MST) -H Telephone: 1-800-992-8470 FAX: (303)860-3699 Ti WELD COUNTY CLERK TO THE BOARD PO BOX 758 GREELEY CO 80632-0758 FEBRUARY 1, 1996 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. We have included a self-addressed envelope for your convenience. 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 andyour 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 either equals or exceeds $25.00 or at such time during each fiscal year when all amounts due of $5.00 or 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: Lease Ownership / Name and Address, P.O. Box 5568, Denver CO 80217 Be sure to indicate your owner and tax identification numbers 2476739 B-1532 P-612 02/16/96 03:13P PG 2 OF 3 000000069 MINERALS MANAG EMENT SERVICE R 0 . 0624689 000006556 WALSH FRANK H R 0 . 0009446 000006556 WALSH FRANK H W 0 . 2317733 000053723 WELD COUNTY R 0 . 0392169 000143425 WALSH PRODUCTI ON INC R 0 . 0022040 000143425 WALSH PRODUCTI ON INC W 0 . 5408044 000306327 ACORN RESOURCE S INC 0 0 . 0037518 000317916 MCNAY J/T JAMES B & NANCY L 0 0 . 0018467 000317916 MCNAY J/T JAMES B & NANCY L R 0 . 0042124 000323584 D & J TRUST 0 0 . 0249876 . 000330036 GILBERT ROBERT M R 0 . 0181363 000338569 MCNAY JAMES W 0 . 0317971 000341322 GREEN J/T SAMUEL P & ELIZABETH 0 0 . 00iiu8G 000341322 GREEN J/T SAMUEL P & ELIZABETH R 0 . 0025274 000341322 GREEN J/T SAMUEL P & ELIZABETH W 0 . 0190783 000341323 VANDAGRIFF J/T BILLY JIM & JUDY 0 0 . 0007386 000341323 VANDAGRIFF J/T BILLY JIM & JUDY R 0 . 0016849 000341323 VANDAGRIFF J/T BILLY JIM & JUDY W 0 . 0127188 3 /7 /96 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. 3 BY: t /' , . ..i L!",.`Z ,,,,County Attorney - '--1- 2476739 B-1532 P-612 02/16/96 03:13P PG 3 OF 3 PAGE 1 Hello