HomeMy WebLinkAbout20240239.tiffSUBJECT: Change Of Address
Dear Interest Owner:
If you have not submitted a change of address, please complete, sign, and
date the following information and return to:
Chevron U.S.A. Inc.
Land Ownership
PO Box 4538
Houston, TX 77210
Or Fax To: 1-866-819-1448
Weld County 0008200344
Name: Board of Commissioners Owner Number:
Address: P.O. Box 758
City:Greeley State: CO Zip Code: 80632-0758
Tax ID or Social Security Number: 84-6000813
Telephone Number ( 970 ) 400-4225 (Optional)
Kevin D. Ross, Chair, Board of
Authorized By: (Name and Title)' S ty Commissioners
Signature (Required): 7 `/ • Date: JAN 2 9 2024
Thank you,
Royalty Disbursements
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