HomeMy WebLinkAboutC2007-114 - 3/20/2007 - ApprovedBiake Production C~ompany. ~nc.
1601 IdW Expressw~ay, Suite 12U0
fJklal~ma Cit_y, OK 73118
~40512~6-9800 FAX ~405) 286-9799
TIADOA Model Form
Division Order (Adopted 9/43)
~-~ llIVISION ORDER
7~0: vt~1..AKE ~RODUCTION COMPANY, INC
1601 N~Expressway. Suite (20Ct Date: November 14, 2006
OKLAH~MA CITY, OK 731 ] 8
Property 1Wme: Hulldale Unit (Penn Reefl
Opet~uor: Blake Production Company, Inc
County and ~tate: Schleicher County, Texas
Property Descrip~on: Unitization
Production: Qil _ Gas
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Owner I~ame GiTY OF COIZi-i15 ~F-;RISTI
A~tn: Di~'ector of City Libraries _/~~,P~~ ~- G ~~~~ LF f
Address: F'.O. Box 9277
(~rpus Christi, Texas 78469-9277
Type of Interest: Royalty
Decimal Interest: .00007559
The undersigned c~ifies the ownership of the decimal interest in production or proceeds as described above payable by Blake Production
Company, Inc. (F~yor>
Payor shati be notifi~d, in writing, of a~y change in ownership, decimal interest, or payment address. All such changes shall be effective the
first day of the mont~ following receipt of such notice.
Payor is authorized b withlMOld payment pendffig resolution of a title dispute or adverse claim asserted regarding the interest in production
claimed herein by tt1~ under~igned. The undersigned aKrees to indemnify and reimburse Payor any amount attributed to an interest to which the
undersigned is not eptitled.
Payor may accrue pr~rceeds euitil the total am~unt equals one hundred dollars ($100.00), or pay annually, whichever occurs first, or as required
by applicable state st~ttute.
This Division Order dces nat amend any ]ease or operating agreement between the undersigned and the lessee or operator or any other
contracts for the purc~ase of oil or gas.
Ia addition to the tertf~s and conditions of this Division Order, the undersigned and Payor may have certain statutory rights under the iaws of
the state in which the property is located.
Special Ctauses: «A~i/A>>
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Owner(s) Signature(s): ~rpy~d 86 b ~ftl~ ~ ~ ~
Owner(s) Tax ID Numbers ~~ ~ Q~,S ;~~
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Owner Daytime Te]ep~one #: .~~ /- ~~ , ? d . ~
--~ -____ ~~ ~ ~~.d
Owner FAX Telephone ~- .~(~ r~ ~ ---~--~~f ~
. _ _ _- -- ~ --?o ~ ~Y
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Owner E-Mail Address: ~e r.f,9 C C~~~ ~~
200'-114 You to furnish your Social Securiry or Taxpcryer ldentification Number.
Q3~20/07 'll result in 29% tctt withholding and will not be refundable by Payor.
Res02? 177 ;~CUTED COPYAND RETAIN THE OTHER FOR YOUR RECORDS.
Blake Producti~n ( ~~~rnpan~
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