HomeMy WebLinkAbout960389.tiff AUTHORIZATION TO RECEIVE OIL AND DIRECTION FOR PAYMENT
TO: TEXACO TRADING AND TRANSPORTATION INC. ( TTTI ) Lease No. 053710
Lease Ownership
Post Office Box 5568
Denver, Colorado 8O217-5568
Toll Free 1-8OO-992-847O A.R247t 73a 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 17 LEASE
located in WELD County, State of COLORADO
described as:
TOWNSHIP 8 NORTH - RANGE 58 WEST
SECTION 6: LOTS 8, 9, 10, 11, 13, 14
TRACT PARTICIPATION FACTOR - 0.0388120
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WO The undersigned warrants to 'MI 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: 0.0783948
TRANSFERRED FROM: 999999999
CURRENT INTEREST(S) IN PAY STATUS FOR THIS LEASE:
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C N GREELEY CO 80832-0758
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ch 8 In the event of a dispute concerning title to any portion of the proceeds of this interest, TIM may hold the proceeds until it receives
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avidence of title satisfactory to TTTI. The undersigned agrees to notify T'ITI in writing of any change in the decimal interest and all
,.i :hanges shall be effective the first day of the month following MI's receipt of such notice. For any claims arising from the undersigned's
<r a) allure to provide written notice, the undersigned will fully indemnify and hold TTTI harmless. If action or inaction by the undersigned
N 3 causes VITT to over-pay this interest, then 1'1'11 may recoup the overpaid amount from the undersigned's interests in other leases.
Finally, all payments shall be subject to all present and future laws, regulations and orders.
OWNE,R(S) PAYMENT FOR THIS INTEREST SHOULD BE SENT TO:
7X. U- CLERK TO THE BOARD OF WELD COUNTY COMMTSSTONER:
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1861 h9 PO BOX 758
EPUTY CLERK TO
O, C 1T:+S ',ki i0 TAX ID NUMBER THE BOARD GREELEY, CO 8O632-O758
DAYTIME TELEPHONE NUMBER ( 97O 1356-4000 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.
REC'D
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SUSPENSE
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ANALYST ZIP + 4 CODE IS REQUESTED
/`7/96:1 O1 96O2O11O4554 VAO3CCP
GEv �9 960389
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TEXACO TRADING AND TRANSPORTATION INC.
CUSTOMER SERVICE
Office Hours 6:30 A.M. - 4:30 P.M. (MST)
Telephone: 1-800-992-8470 FAX: (303)860-3699
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WELD COUNTY CLERK TO THE BOARD
PO BOX 758 -�
GREELEY CO 80632-0758 z i - 0
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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 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 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
2476738 8-1532 P-611 02/16/96 .03:12P PG 2 OF 3
000006556 WALSH FRANK H R 0 . 0018883
000006556 WALSH FRANK H W 0 . 2160623
000053723 WELD COUNTY R 0 . 0783948
000143425 WALSH PRODUCTI ON INC R 0 . 0044059
000143425 WALSH PRODUCTI ON INC W 0 . 5041452
000306327 ACORN RESOURCE S INC
000317916 MCNAY J/T JAMES B & NANCY L 0 0 . 0036914
000317916 MCNAY J/T JAMES B & NANCY L R 0 . 0084206
000330036 GILBERT ROBERT M R 0 . 0362546
000338569 MCNAY JAMES
000341322 GREEN J/T SAMUEL P & ELIZABETH 0 0 . 0022148
000341322 GREEN J/T SAMUEL P & ELIZABETH R 0 . 0050524
000341322 GREEN J/T SAMUEL P & ELIZABETH W 0 . 0381375
000341323 VANDAGRIFF J/T BILLY JIM & JUDY 0 0 . 0014766
000341323 VANDAGRIFF J/T BILLY JIM & JUDY000341323 VANDAGRIFF J/T BILLY JIM & JUDY W R 0 . 0033682
0 . 0254250
-/7 /94
• 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.
7
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unty Attorney - �__
2476738 B-1532 P-611 02/16/96 03:12P PG 3 OF 3
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