THE DIVISION ORDER SHOULD NOT BE ALTERED IN ANY WAY UNLESS ACCOMPANIED BY DOCUMENTARY EVIDENCE SUPPORTING THE CHANGE. ALTERATION OF THIS DIVISION ORDER MAY RESULT IN SUSPENSION OF YOUR FUNDS. PLEASE DO NOT REMOVE ANY ATTACHMENTS TO THE DIVISION ORDER.
EXAMINE the document for correctness of spelling and net revenue interest. If your name and address are correctly shown:
INDIVIDUALS: Sign your name as shown on the instrument (because it reflects record title) on the line above “Owner Signature #1.” If your name has changed, please alter the division order when executing and attach a copy of the Marriage Certificate, Divorce Decree or Judicial Document, Change of Name or supporting document.
CORPORATIONS: If signing for a corporation, sign your name on the line above “Owner Signature #1 and print the name of your corporate title and corporation on the line immediately below.
PARTNERSHIPS: If signing for a partnership, sign your name on the line above “Owner Signature #1 and print the name of the partnership on the line immediately below. All partners must sign unless signed by an authorized partner, in which case the supporting evidence of authority must be attached.
SIGNATURE BY SECOND PARTY: If the instrument is being signed by more than one party (such as a husband and wife, trustee, partnership, etc.), sign your name as shown on the instrument (because it reflects record title) on the two “Owner Signature” lines. If the instrument is being signed by an agent, attorney-in-fact, guardian, estate representative, or trustee of any party other than the named interest owner, attach the supporting evidence of the right vested in the signatory party.
THE SIGNATURE(S) MUST BE WITNESSED BY TWO PERSONS NOT RELATED TO THE PARTY SIGNING. We must have two witnessing signatures in total. These signatures are to verify that you are, in fact, the person who is signing the Division Order.
NOTE: CORPORATION SIGNATURES MUST BE ATTESTED, CORPORATE SEAL AFFIXED, AND TITLE OF SIGNATORY PARTY SHOWN. IF NOT PREVIOUSLY FURNISHED, A CERTIFIED COPY OF AUTHORITY OF EXECUTING OFFICER MUST BE SUBMITTED.
TAXPAYER ID OR SOCIAL SECURITY NUMBER:
Please complete and return the enclosed W-9 form. It MUST be completed and returned to us per IRS rules. Federal regulations require that we report payments of this nature to the Internal Revenue Service. Failure to provide this information may result in backup withholding.
Indicate in the space provided the address to which checks are to be mailed (if incorrect on the division order). PRINT OR TYPE. DO NOT ABBREVIATE. If you are already receiving checks from this company, be sure to show the same address for all documents.
FOR FUTURE REFERENCE:
CHANGE OF ADDRESS: You should notify us promptly, in writing, of any change to your mailing address. You must sign your address correction request and include your social security number or tax identification number (TIN).
AFTER COMPLETE EXECUTION OF THE DIVISION ORDER: Please return one (1) copy to the address below and keep the other copy marked “For Your Records.”
SEM Operating Company LLC must receive the signed Division Order by the 20th of the month in order for your account to be placed in a “pay” status for the current accounting distribution cycle. If we receive the Division Order after the 20th of the month, your account may be held in suspense until the next month’s accounting cycle. Our policy is to remit payments monthly when your account reaches $50. Accounting cycles are processed at the end of each month. Royalty checks are mailed out and direct deposits are processed on the 25th of the month following a cycle.
PLEASE KEEP THIS INFORMATION FOR FUTURE REFERENCE
SEM Operating Company LLC
909 ESE Loop 323, Suite 777
Tyler, Texas 75701