L . - imaging.occeweb.comimaging.occeweb.com/OG/Well Records/00541A29.pdf · Well Class: [ROL LIGAS...
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ar • ..Wiructions OKLAHOMA CORPORATION COMMISSION Oil & Gas Conservation Division Post Office Box 52000 Oklahoma City, OK 73152-2000 A. Please type or print using black or blue ink. B. Form must be signed by former operator and new operator. C. Signatories - be listed on their company's Form 1006B. D. Fill in the complete legal description below. E. Direct questions to Well Records (405) 521-2271. Transfer of Operator Single Oil or Gas Well OAC 165:10-1-15 API No 3508324061 . OTC Prod 083210349 Unit No. Surface Location Sec . 9 Twp 17N Rge. 3W SW SE 1/4 1/4 SE SW 1/4 1/4 Ft FSL of Qtr Sec 200 Ft FWL of 2160 Qtr Sec County Logan Current Well Name/Number Mallard # 1-16H Original Well Name/Number same Unit Name (if applicable) Well Class: [ROL LIGAS ODRY Specify a well status: (see back page) Ei ND El SP ig AC .R4A El TM This form must be filed with the OCC within 30 days of transfer of the well. FEE: $25.00 OAC165:5-3.1(NORN) (SEE .ACK PAGE FOR PAYMENT INFORMATION) Form 1073 Rev. 2016 DO NOT WRITE INSIDE THIS BOX OKLA EORP COMM AMR ihte: 04/28/2017 Time: 15:12 r_ase: 0000Ton0 Cashter: ROZ rayon MAHAFFEY & GORE 2'peck 1 1962 $25.00 WELL TRAWSFER-OFEF Use this form to transfer single oil or gas wells only. Use Form 1073MW to transfer 10 or more wells. Producing formation(s) Mississippian The effective date of transfer of this well, for the purposes of Commission records, is the date that the transfer is approved by the Commission. CURRENT OPERATOR OCC/OTC No 23402 NEW OPERATOR Name U. S. Energy Development Corporation Address 2350 North Forest Rd, Suite 31B City Getzville State NY Zip 14088 Phone 716636-0401 No. FAX No./E-mail I verify that l am the legal operator of record with authority to transfer operatorship of this well, that the facts presented herein are true and correct, and that l have completed this form as required by the above instructions. (Signatory mus e listed on company's Form 1006B Operators Agreement) 2 / ( L_____. Signature .3 - 1,4(.. LAS 1/. (JAZ- et %CS 1 ,DEdv - r— ame & Title (Typed or Printed) Signed and sworn to before e this ite day of , 2,f2/7—. JOSHUA M SMITH iotary Public, State New York a/ - of Qualified in Erie CountyNota Public My contligsfterleRilMs: .... i lf crimisrfnir.... Ithl.... n4 Co OCC/OTC No. 23030 Name Stephens Production Company Address P O Box 2407 City Fort Smith Phone No. 479-783-4191 State Zip AR FAX No./E-mail 72902 Being the new operator, as of the effective date of transfer, l accept the facts presented as being true and correct and accept the operational responsibility for the well on the described property. (Signatory must be listed on company's Form 10068 Operator's Agreement) -eetstz_ lek • Signature G- E.91 0 .0-E. i" • f5R A 0 L.E./ Jtce PRES! Osivr Li9iu6 Name & Title (Typed or Printed) Signed and sworn to before me this c ' j " -' day of 4Q.Le.,",-A4g-er , t( s2 . _ 0 01 111 ”1444 0. OWILL/441 6 , c p .. ......... 4i!" •%\''';?" PLj ko .. e. I S; Notary Public . liytommission exhirea 7 — Z-- 4 1 AKKANSAS E = l verify under oath that l have exercised due diligence in attempting to lacatithe current operator of record according to OCC records, who has abandoned the listed well/lease and cannot be located to obtat siNtre. I haOlitOefla certified copy of the recorded lease or assignment, or certified copies of a journal entry of judgment or bankruptcylispc4dieftuaii*pC 165:10-1-15(b). 1, ; 94143EXPg-S 1 ';,.k Signaturdi tl"" Signed and sworn to before me this My commission expires: day of FOR OCC USE ONLY Surety Approved Date Well Records Review: MAY n 7 7ni7 MAY 0 2 2017 WELL i'ZECORDS APPROVED Notary Public By processing this Form 1073, the Oklahoma Corporation Commission has approved the contents thereof as to form only. The Oklahoma Corporation Commission does not warrant that the facts provided by the operator are true. Transfer is not effective until approved by the Well Records Department.
Transcript of L . - imaging.occeweb.comimaging.occeweb.com/OG/Well Records/00541A29.pdf · Well Class: [ROL LIGAS...
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..Wiructions OKLAHOMA CORPORATION COMMISSIONOil & Gas Conservation Division
Post Office Box 52000
Oklahoma City, OK 73152-2000
A. Please type or print using black or blue ink.B. Form must be signed by former operator and new operator.C. Signatories - be listed on their company's Form 1006B.
D. Fill in the complete legal description below.
E. Direct questions to Well Records (405) 521-2271.
Transfer of Operator
Single Oil or Gas WellOAC 165:10-1-15
API No 3508324061 . OTC Prod 083210349Unit No.
SurfaceLocation
Sec. 9Twp
17NRge.
3W SW SE1/4 1/4
SE SW1/4 1/4
Ft FSL ofQtr Sec
200 Ft FWL of 2160Qtr Sec
County Logan
Current WellName/Number
Mallard # 1-16H
Original WellName/Number same
Unit Name(if applicable)Well Class: [ROL LIGAS ODRY
Specify a well status: (see back page)Ei ND El SP ig AC .R4A El TM
This form must be filed with the
OCC within 30 days of transferof the well.
FEE: $25.00OAC165:5-3.1(NORN)
(SEE .ACK PAGE FOR PAYMENT INFORMATION)
Form 1073Rev. 2016
DO NOT WRITE INSIDE THIS BOX
OKLA EORP COMM
AMRihte: 04/28/2017 Time: 15:12
r_ase: 0000Ton0 Cashter: ROZrayon MAHAFFEY & GORE
2'peck 11962 $25.00WELL TRAWSFER-OFEF
Use this form to transfer single oil or gas wells only. Use Form 1073MW to transfer 10 or more wells.
Producingformation(s)
Mississippian
The effective date of transfer of this well, for the purposes of Commission records,is the date that the transfer is approved by the Commission.
CURRENT OPERATOR OCC/OTC No
23402 NEW OPERATORName
U. S. Energy Development Corporation
Address2350 North Forest Rd, Suite 31B
CityGetzville State NY Zip
14088
Phone 716636-0401No.
FAX No./E-mail
I verify that l am the legal operator of record with authority to transferoperatorship of this well, that the facts presented herein are true and correct,and that l have completed this form as required by the above instructions.
(Signatory mus e listed on company's Form 1006B Operators Agreement)
2 / ( L_____.Signature
.3-1,4(.. LAS 1/. (JAZ- et %CS 1 ,DEdv-r—ame & Title (Typed or Printed)
Signed and sworn to before e
this ite day of , 2,f2/7—.
JOSHUA M SMITHiotary Public, State New York a/-of
Qualified in Erie CountyNota PublicMy contligsfterleRilMs: .... ilf
crimisrfnir.... Ithl.... n4Co
OCC/OTC No.23030
Name Stephens Production Company
Address P O Box 2407
City Fort Smith
PhoneNo.
479-783-4191
State ZipAR
FAX No./E-mail
72902
Being the new operator, as of the effective date of transfer,l accept the facts presented as being true and correct and accept theoperational responsibility for the well on the described property.
(Signatory must be listed on company's Form 10068 Operator's Agreement)
-eetstz_ lek •Signature
G- E.910.0-E. i" • f5R A 0 L.E./ Jtce PRES! Osivr Li9iu6
Name & Title (Typed or Printed)
Signed and sworn to before me
this c'j"-' day of 4Q.Le.,",-A4g-er , t(s2 ._001111”14440.OWILL/4416,
cp.. .........
4i!" •%\''';?" PLjko..e. IS; Notary Public.liytommission exhirea 7 — Z--41
AKKANSAS E = l verify under oath that l have exercised due diligence in attempting to lacatithe current operator of record according to OCC records,who has abandoned the listed well/lease and cannot be located to obtat siNtre. I haOlitOefla certified copy of the recorded leaseor assignment, or certified copies of a journal entry of judgment or bankruptcylispc4dieftuaii*pC 165:10-1-15(b).
1,;94143EXPg-S1';,.k Signaturdi tl""
Signed and sworn to before me this
My commission expires:
day of
FOR OCC USE ONLY
Surety Approved Date
Well
Records
Review:
MAY n 7 7ni7 MAY 0 2 2017
WELL i'ZECORDS
APPROVED
Notary Public
By processing this Form 1073, the Oklahoma CorporationCommission has approved the contents thereof as to form only. The
Oklahoma Corporation Commission does not warrant that the facts
provided by the operator are true.
Transfer is not effective until approved
by the Well Records Department.
Janie Hlinicky
From: Janie HlinickySent: Tuesday, May 02, 2017 12:09 PMTo: '[email protected]'; '[email protected]'Subject: Well Transfers
To Whom It May Concern,
We have approved the transfer of the 4 wells listed below from U S Energy Development Corp (23402) to Stephens Production
Company (23030).
3508324031 CHAMBERS 1-5H 8-17N-3W
3508324061 MALLARD 1-16H 9-17N-3W
3508324066 RUDDY DUCK 1-17H 17-17N-3W
3508324094 SNIPE 1-30H 30-17N-3W
Images of the approved forms will be available online in the next few days.
Sincerely,
Janie HlinickyOklahoma Corporation CommissionWell Records SectionPhone: 405.521.2271Fax: 405.522.0854
Oklahoma Corporation Commission
There are new forms for transfers. 1073 for single well, 1073MW for 10+ wells, 10731 for single injection well, 10731MW for
10+ injection wells. Fees for transfers went into effect August 25, 2016. The amounts of the fees are on the forms.
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