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Home My WebLink About20153024 Kerr-McGee Onshore LP Division Order WELD COUNTY COLORADO See reverse for list of C/O BOARD OF COUNTY COMMIS Properties and Interests. PO Box: 758 RECEIVED) GREELEY, CO 80632 AUG 2 7 20S Effective Date: Date of First Sales WELLS COUNTY COMMISSIONERS The undersigned certifies the ownership of their decimal interest in production as described above payable by Kerr-McGee Onshore LP (Payor). Payor shall be notified, 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. Payor 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 Payor any amount attributable to an interest to which the undersigned is not entitled. Payor may accrue proceeds until the total amount equals $100, or Sept. 30 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 Payor may have certain statutory rights under the laws of the state in which the property is located. Note: NADOA Model Form Division Order(Adopted 9/95) Special Clause(s): Payee agrees that by execution of this DO and returning the signature page to Payor that the signature page will be attached to Payor's duplicate original of this instrument and treated as an original for all purposes. RV37471504 WELD COUNTY COLORADO CIO BOARD OF COUNTY COMMIS XXX-XX-0813 _Barbara Kirkmeyer. Chair gnature of Witness Board of Weld County Commissioners Owner Address(if different from above) SEP 1 2015 ATTEST: dyr 6: JC,LLD;(..k. City, State Zip Code WELD S U TY CLERK TOT E BOARD Owner Daytime Phone BY: DEPUTY CL K TO THE 1T" ` T Ada Email Address 361 thl211 *Failure to furnish your Social Secu ��:- ~ � t in withholding tax in accordance with federal law and any tax withheld refundable by payor. **All individual parties must complete and r�y .► �9 to ensure proper payment.Additional forms may be obtained at www.irs.gov Please return to: / Date Prepared: August 20, 2015 Kerr-McGee Onshore LP a � Prepared By: LOREN PEDRICK-SH P.O. BOX 1330 - Suspense Flag: N HOUSTON, TX 77251-9874 9 /t°. —/7 Escheat Flag: N 2015-3024 C/> 1-800-359-1692 commt Anc n„L„ q-11,0 /6 -Io15 Page 1 of 2 LEOD OA Property Property Name Product State/County Int Type Int Seq Interest 330802 KERR 29C-12HZ CODL All Products CO/WELD RI 1 0.00002019 Legal Description: TO RANGE 67 WESTORTH / p) /1 5 /2 3 3 c, i SECTION 12:W2 (J ,J STION13: W2 CONTAINI 637.758 ACRES M/L FORMATION: CODELL *Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withheld will not be refundable by payor. **All individual parties must complete and return the enclosed W9 to ensure proper payment.Additional forms may be obtained at www.irs.gov Please return to: Date Prepared: August 20, 2015 Kerr-McGee Onshore LP Prepared By: LOREN PEDRICK- SH P.O. BOX 1330 Suspense Flag: N HOUSTON, TX 77251-9874 Escheat Flag: N 1-800-359-1692 Page 2 of 2 ■ n Check out the Anadarko Owner Relations Website : Go to www. anadarko. corm1, click on About 2 Anadarko, click on Owner Relations, Our Owner Relations website provides details regarding F.7 issues/questions about royalty checks, owner interest and much more ! Dear Interest Owner : 1 . Enclosed are two copies of your Division Order or Transfer Order. Please execute ( in front of two witnesses) the document stamped " Return This Copy" and retain the one marked "Your Copy" for your records . a . Sign exactly as shown on the Division Order or Transfer Order . Signatures must be witnessed by two people . If joint ownership, all owners will be required to sign , but may sign separate copies . Signatures by Agents, Attorneys- in - Fact, Guardians or Trustees must be verified by attaching evidence of the right to sign in that manner, such as a copy of the Power of Attorney . b . If a W8 or W9 is enclosed with this mailing , it MUST be completed and returned to us per IRS rules . Failure to provide this form WILL result in withholding tax in accordance with federal law and any tax withheld will not be refundable by payor. If the name on the Division Order or Transfer Order does not match the name on your Social Security Card, please advise us, in writing, of the differences . c. Please note. If there is not a WS or W9 enclosed with this mailing, we have valid tax information on file and no further action on your part is necessary. 2 . Please address all correspondence, including your executed Division Order, to the following address : Kerr McGee Oil & Gas Onshore Attn : Land Administration P . O . Box 1330 (AHT) Houston, TX 77251 - 9874 3 . Please send all written CHANGES OF ADDRESS to the address listed above, or submit changes through the Oildex website . ( Please see the reverse side of this page for instructions . ) 4 . NAME AND OWNERSHIP CHANGES must be submitted in writing to the above address . Please include proper documentation confirming the change : a . For Name Changes : Marriage Certificate, Divorce Decree, etc . b . For Ownership Changes : Deeds, Assignments, etc . , must be recorded in the County ( Parish ) in which the property is located prior to sending to our office . Copy of the document sent in must have evidence of the recording (e . g . , the recording stamp) on it. c . For Changes due to Death of an Owner: As a general rule, we require complete copies of probate proceedings rendered by a court having jurisdiction over the property in question . If the Estate was not probated , or if it was probated in a different state, other documentation may be required . 5 . When you wish to make an inquiry or request a change, please have available as much of the following information as you can : -Owner Number -County and State where well is located -Well name and/or property number -Your telephone number with AREA CODE 6 . Anadarko Owner Relations toll -free telephone number : 1 - 800- 359- 1692 . Our Owner Relations Agents are committed to monitoring and returning calls in a timely manner. Our goal is to return your call within two business days . 7 . For access to check information : http ://www . oildex . com . Please see the reverse side of this page for instructions . Anadarko E &P n h� s r oe LLC Owner On - Line Access Upon receipt of your first check you will be able to access your check/ EFT statements, access your 1099 form , submit a change of address form , or sign up for direct deposit via the internet. Go to www . oildex . com . This will not be available until you receive your first check/deposit. Locate the "Owner Relations Login " section and click on the link. MSS LOGS • 011d € :x Home Products Resources About ajalipropeatinis This will bring you to the " Oildex Account Login " page . Click the login prompt located in the " Owner Relations" box . Owner Relations 4 Sr karailt Onartia., a t ONi a 149 IV r 104W?Pa• Ovnitte 34 , .,:iWYc04dbCf.la',asy:.i; • 4 ::.,w::r`.:a'® aa.V g cam.P b *. Click on Anadarko . This will bring you to the login screen . If you are a first time user, be sure to click on the "I am a first time user" hyperlink. You will then be prompted to enter your User ID and Temp Password . Your User ID is your six-digit Anadarko or Kerr- McGee Owner Number located at the top of your check detail . To access Oildex, only enter the six-digit owner number, leaving off the RV/04 or JV/01 on either end . ( Example : For RV12345604 or JV12345601 , the User ID would be 123456 . ) Your Temp Password is normally the last six digits of the Tax ID I Social Security # on your account. ( Example : For SS# 123 -45 -6789, the Temp Password would be 456789 . ) Once you log in , you will be prompted to choose a new password . • To view your check/ EFT statements — Log in and go to the Inbox tab . Then , select "All " in the Date Selection dropdown box . View a statement by clicking the hyperlink in the Check # column . Please note : If you have never received a check/ EFT from Anadarko, Kerr- McGee, Lance or Howell, no information will be posted on the Oildex website . • To view your 1099 form — Log in and go to the Inbox tab . Then, click " Display IRS 1099s". View a 1099 form by clicking the hyperlink in the ID # column . • To change your mailing address — Log in and go to the Forms tab . Then , click the "Address Change" hyperlink under the list of Owner Relations Forms . Complete the information and click Submit. • To sign up for Direct Deposit — Log in and go to the Forms tab . Then , click the " Direct Deposit" hyperlink under the list of Owner Relations Forms . Complete the information and click Submit. • If you have any issues accessing www . oildex . com, please contact Oildex support directly at support@oildex . com and provide Anadarko's name along with your six-digit owner number . Alternatively, you may contact Anadarko Owner Relations at owner. relations@anadarko . com or 1 -800-359- 1692 . I a 3g es 0 N C3 8e i 0 O e tD 8 • r-- 03 cla N: in w tat% Qm � O 0 gi Li d Q m ei salieJ N • cn CU N V t to Ct = m anal U =o Op cu' U u -- N t,(5);C 3 Cr') "' N Ira ut` ,•', ...a U (n a4 . ... N ‘,..,.✓ R in O u O _ . -� i .0 190.04 ig. CO CI) oN O CI O '� al al CO Ch oo E--+ O r... O 0 r O f � en t.:0) . O U ' O C, I I Ca cn X o f--+ LI as '4-4 O C..) V)wet t U k c� e cd • i C.:7 1 ragO — 0 ' ot , . s„ ^, ...,44 z E CA 000 4-4 ct > a) &-4 • i v N U> 3 M N ;� > co N Z. cn t C, C3 .° o N 41 aC5r" cd J �-'cri .•^yr3 —c-ri f U ih GI N M o �; a v.) .Q ' < z ;;. > '"" U O •,,. ` < L..Yt G cl el lise tiro ear a) N v C4 v z.., v1 N ,rota Ct in ' ~ .. .� COGIS - WELL Information Page 1 of 1 COGIS - WELL Information Scout Card eit Related O4. Insp . Q MIT kit GIS a Doc a COA 11 Wellbore m ay Orders Surface Location Data for API # 05- 123-38981 Status : PR 6/ 1 /2015 Well Name/No : KERR #29C - 12HZ (click well name for production ) Operator: KERR MCGEE OIL & GAS ONSHORE LP - 47120 Status Date : 6/1 /2015 Federal or State Lease #: County : WELD # 123 Location : SESW 13 2N 67W 6 PM Field : WATTENBERG - #90750 Elevation : 4 , 886 ft. Planned Location 576 FSL. 1936 FWD Lat/Long : 40 . 13233/- 104 . 841672 Lat/Long Source : Field Measured Job Date : 5/17/2015 Frac Reported : 7/20/2015 Days to report: 52 Job End Date : 5/29/2015 Chemical Disclosure Registry Wellbore Data for Sidetrack #00 Status : PR 6/ 1 /2015 Spud Date : 10/12/2014 Spud Date is : ACTUAL Wellbore Permit HORIZONTAL Permit #: Expiration Date : 2/22/2016 4 : 32 : 31 PM Prop Depth/Form : 17409 Surface Mineral Owner Same : Mineral Owner: FEE Surface Owner: FEE Unit: Unit Number: Formation and Spacing : Code : CODL , Formation : CODELL , Order: , Unit Acreage : 640 , Drill Unit: GWA Casing : String Type : SURF , Hole Size : 13 . 5 , Size : 9 . 625 , Top : 0 , Depth : 1000 , Weight: 36 Cement: Sacks : 380 , Top : 0 , Bottom : 1000 , Method Grade : Casing : String Type : 1ST , Hole Size : 8 . 75 , Size : 7 , Top : 0 , Depth : 7788 , Weight: 26 Cement: Sacks : 820 , Top : 0 , Bottom : 7788 , Method Grade : Casing : String Type : 1ST LINER , Hole Size : 6 . 125 , Size : 4 . 5 , Top : 6788 , Depth : 16696 , Weight: 11 . 6 Cement: Sacks : , Top : , Bottom : , Method Grade : Wellbore Completed Completion Date : N/A Measured TD : Measured PB depth : True Vertical TD : True Vertical PB depth : Top PZ Location : Sec: 13 Twp : 2N 67W Footage : 1140 FSL 1554 FWL Depth Bottom Hole Location : Sec: 12 Twp : 2N 67W Footages : 460 FNL 1515 FFWLL Depth Formation Log Top Log Bottom Cored DSTs Completed information for formation N -COM Status : PR 6/ 1 /2015 1st Production Date : N/A Choke Size : Status Date : 6/ 1 /2015 Open Hole Completion : Commingled : Production Method : Formation Name : NOT COMPLETED Status : PR Tubing Size : Tubing Setting Depth : Tubing Packer Depth : Tubing Multiple Packer: Open Hole Top : Open Hole Bottom : No Initial Test Data was found for formation N-COM . No Perforation Data was found for formation N-COM . http : //cogcc . state . co . us/cogis/FacilityDetail . asp?facid= 12338981 &type=WELL 9/ 1 /2015 COUNTY ATTORNEY STAFF APPROVAL This is to affirm the attached Division Order and authorization to receive payment for an oil and gas well has been reviewed by the County Attorney ' s staff as to form and legal description . Well Name ( s ) : KERR 29C - 12HZ CODL File Location ( s ) : LE0082 BY : �� DATE : `, I _ Bruce Barker - County Attorney NOTES : . 103 mineral acres/ 637 . 758 acres spacing unit * 12 . 5 % = . 00002019 MATCH Hello