Request For Change Of Annual Rental Payor Form - Designating Third Party As Payor - 2004
Download a blank fillable Request For Change Of Annual Rental Payor Form - Designating Third Party As Payor - 2004 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Request For Change Of Annual Rental Payor Form - Designating Third Party As Payor - 2004 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1ONLINE Version
New Mexico State Land Office
Oil, Gas, and Minerals Division
Request for Change of Annual Rental Payor
Designating Third Party as Payor
We, _____________________________________________________ Lessee of Record of
leases(s) number _____________________________________________________________
_____________________ [attach additional page if necessary] to which this request applies,
AND_________________________________________________________ Third Party, do
hereby concur and agree that future billings from the New Mexico State Land Office (SLO) for
annual rentals of the specific leases identified above be sent for payment directly to this Third
Party designee:
Attention:
________________________________ Telephone _____________________
Company:
_____________________________________________________
Address:
_____________________________________________________
City ST Zip: _____________________________________________________
I, the Lessee of Record, understand that this designation does not relieve me as Lessee of
Record of any payment obligations under my leases(s), and any nonpayment of SLO billings or
invoices by the Third Party designee shall be deemed as nonpayment by me, the Lessee of
Record. As Lessee of Record, I acknowledge that the changing of billing to a third party
designee is done strictly as an administrative convenience for the Lessee of Record and is not a
waiver by the SLO of any performance obligations of the Lessee of Record under the terms of
the leases identified above with the SLO.
Signatures below indicate mutual agreement and concurrence of Lessee and Third Party.
_________________________________
__________________________________
LESSEE OF RECORD
THIRD PARTY – COMPANY NAME
By_______________________________
By _______________________________
PRINT NAME
PRINT NAME
Title _____________________________
Title ______________________________
__________________________________
___________________________________
SIGNATURE
DATE
SIGNATURE
DATE
NOTE
– Both parties may want to consider filing an assignment of record title ownership for
the leases(s) referred to in this agreement.
ONLINE Version
October 2004
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal