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Alaska Oil and Gas Conservation Commission
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HomeMy WebLinkAboutNikolaevsk - Hilcorp Alaska, LLCState of Alaska AOGCC
Production Files
Year0
: 2017
Field & Pool: NIKOLAEVSK
Operator: HILCORP
Hilcorp Alaska, LLC
Name of Operator
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Nikolaevsk
Regulatory Lease
I hereby certify that the foregoing is true and correct to the best of my knowledge.
1
Signed Ci.6'JlalLP �.e/t
Cortney Dyer TOTAL
Title_ Production Analyst Date: 2/16/2017
DECE 16
Month and Year of Production
-
0
0
0
0
0
0
OIL WATER
GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
FACILITY REPORT OF PRODUCED GAS DISPOSITION
1. Facility Number
2310000004
2. Facility Name
Nikolaevsk Exploration
3. Field
Nikolaevsk
4. Operator
Hilcorp Alaska LLC
5. Month/Year of Disposition
January-17
Disposition
Volume MCF
20. For production from multiple pools, list contribution of each pool as a percent of
Total Volume.
6. Sold
7752
Pool Name
Pool Code
Percent
7. Reinjected
0
UNDEFINED GAS
563500
100.00%
8. Flared or vented 1 hour or less
0
9. Flared or vented more than 1 hour (see instr.)
0
10. Pilot and Purge
0
11. Assist Gas
0
12. Fuel gas used in lease operations.
745
13. Other (see instructions)
0
Official Use Only
Authorization >1 hr:
Safety
MCF
14. TOTAL VOLUME (ITEMS 6-13)
8497
Lease Use
MCF
15. NGL Gas Equivalent
0
Conservation
MCF
16. Purchased gas
p
Waste:
MCF
17. Transferred from:
0
Commissioner Date
18. Transferred to: (Express as a negative #)
p
19. Remarks:
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Note: All volumes must be corrected
Signature Title Production Analyst to pressure of 14.65 psia and to a
temperature of 60o F. Authority 20
Printed Name Cortney Dyer Phone 713-289-2881 Date 2/16/2017 AAC25.235.
Form 10-422 Rev. 5/2009 INSTRUCTIONS ON REVERSE SIDE Submit in Duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
20 nnr. 25 230
Name of Operator:
HILCORP ALASKA, LLC
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
DECEMBER 2016
1. Well No.
2. API No.
50-XXX-XXXXX-XX-XX
3. Type
(see
instruct.)
4. Field &
Pool
Code
5. Method
(see
instruct.)
6. Days in Oper.
7. Avg. FTP
psig (see
instruct.)
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
8. OIL
(BBL)
9.
WATER(BBL)
10. GAS
(BBL)
11. OIL
(BBL)
1 12. WATER
(BBL)
13. GAS
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
31
306
0
115
274
0
1473
18,497
I hereby certify that the foregoing is true and correct
to the best
of my knowledge.
14.
Printed Name: Cortney Dyer
Title: Production Analyst
"�"
Signature: (i.�J1ifLP.ff
�A/o/1
Date: 2/16/2017
TOTAL
0
473
18,497
i ui 1i Iu-4uU RUv. U4/LUuu INJ I KUU I IUNS UN KLVLKbE SIUt Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk Feb-17
Name of Operator Regulatory Lease I Month and Year of Production
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed &,?.�lL , &2
Cortney Dyer TOTAL
Title Production Analyst Date: 3/21/2017
0
0
0
0
0
OIL WATER
409
GAS
7.243
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
7n AAt' 7G non
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
FEBRUARY 2017
1. Well No.
2. API No.
3. Type
4. Field &
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
Pool
(see
psig (see
8. OIL
9.
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
WATER(BBL)
(BBL)
1 (BBL)
I (BBL)
(BBL)
1
Red 01
50-231-20021-00-00
2
563500
1
28
287
0
115
1259
10
1409
7,243
1 hereby certify that the foregoing is true and correct to the best
of my knowledge.
14.
Printed Name: Cortney Dyer
Title: Production Analyst
Signature:
��
i..�'�i�P�
Date: 3/21/2017
Gnu.., 1n_nnr oo., nninnnc
TOTAL
0
409
7,243
401 RUU 1 IUIVJ UN KCV CK.7t Jlut Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk MARCH 2O17
Name of Operator Regulatory Lease Month and Year of Production
Total Wells 1
Total Wells Produced 1
Total Pipeline Runs 0
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
(Total Net Production
11 hereby certify that the foregoing is true and correct to the best of my knowledge.
0
0
0
Signed .>�P/I 0 1,477 13,530
Cortney Dyer TOTAL OIL WATER GAS
Title Production Analyst Date: 4/19/2017
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
2n AAC 25 2sn
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year.
HILCORP ALASKA, LLC
FEBRUARY 2017
1. Well No.
2. API No.
3. Type
4. Field &
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
Pool
(see
psig (see
8. OIL
9.
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
1 WATER(BBL)
(BBL)
(BBL)
I (BBL)
(BBL)
1
Red 01
50-231-20021-00-00
2
563500
1
12
995
0
1123 11,128
0
11,477
113,530
1 hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Cortney Dyer Title: Production Analyst
Signature: C�.NG�jt' �P/j Date: 4/19/2017
�—a
TOTAL
0
1,477
13,530
rorm lU-4U5 rev. U4auUb INSTRUCTIONS ON REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
IHilcorp Alaska, LLC Nikolaevsk APRIL 2017
Name of Operator lRegulatory Lease JMonth and Year of Production
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
0
0
0
0
0
Signed C�.d'/ 11,�. &2 0 1,107 12
Cortney Dyer TOTAL OIL WATER GAS
Title Production Analyst Date: 5/18/2017
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
?n QAr ?r,,),�n
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
APRIL 2017
1. Well No.
2. API No.
3. Type
4. Field &
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
Pool
(see
psig (see
8. OIL
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
WAT(BBL)
�4239
(BBL)
(BBL)
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
10
1,156
0
111
0
1.107
112,390
I hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Cortney Dyer Title: Production Analyst
Signature: (,i�'Q� ��,�'/J Date: 5/18/2017
^—z
I___ — — —_..
TOTAL
0
1,107
12,390
IIVJ I KUU I IUNJ UN KtVtKbt JIUt Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
IHilcorp Alaska, LLC Nikolaevsk MAY 2017
Name of Operator I Regulatory Lease I Month and Year of Production
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed Ci.6'LP�I &l�t
Cortney Dyer TOTAL
Title Production Analyst Date: 6/20/2017
0
0
0
0
0
0 2,019 21
OIL WATER GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
gn AAr qr� 9,in
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
APRIL 2017
1. Well No.
2. API No.
3. Type
4. Field &
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
Pool
(see
psig (see
8. OIL
9.
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
WATER(BBL)
1
(BBL)
(BBL)
I (BBL)
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
14
910
0
1144
11,548
0
12,019
121,674
I hereby certify that the foregoing is true and correct to the best of my knowledge.
14,
Printed Name: Cortney Dyer Title: Production Analyst
,,c
Signature:!A% Date: 6/20/2017
(
TOTAL
0
12,019
121,674
roan iu-405 Rev. u4i2006 INS I HUG I IONS ON REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
IHilcorp Alaska, LLC Nikolaevsk June-17
Name of Operator Regulatory Lease I Month and Year of Production
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed P�PJl
Cortney Dyer TOTAL
Title Production Analyst Date: 7/20/2017
0
0
0
0
0
0 3,874
OIL WATER GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
20 AA(' 25 28n
Name of Operator:
HILCORP ALASKA, LLC
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
�June-17
1. Well No.
2. API No.
3. Type
4. Field
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
instruct.)
& Pool
Code
(see
instruct.)
psig (see
instruct.)
8. OIL
(BBL)
9.
WATER(BBL)
10. GAS
(BBL)
11. OIL
(BBL)
12. WATER
(BBL)
13. GAS
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
30
760
0
1129
874
0
3,874
26,220
I hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Cortney Dyer Title: Production Analyst
Signature: �/f� ��/j Date: 7/20/2017
— --o
TOTAL
0
3,874
26,220
Form 0-405 Rev. 04i2uu6 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk July-17
Name of Operator Regulatory Lease Month and Year of Production
Total Wells 1
Total Wells Produced 1
Total Pipeline Runs 0
Closing Inventory 0
Opening Inventory 0
Other Adjustments 0
(direct or xylene recovered)
Total Net Production 0
1 hereby certify that the foregoing its true and correct to the best of my knowledge.
Signed Cii/1.�lZQ.f/ .U�/,P�l 0 3,755 22,739
Cortney Dyer TOTAL OIL WATER GAS
Title Production Analyst Date: 8/17/2017
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
Name of Operator:
HILCORP ALASKA, LLC
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
IJuly-17
1. Well No.
2. API No.
50-XXX-XXXXX-XX-XX
3. Type
(see
instruct.)
4. Field &
Pool
Code
5. Method
(see
instruct.)
6. Days in Oper.
7. Avg. FTP
psig (see
instruct.)
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
8. OIL
(BBL)
9.
WATER BBL ( )
10. GAS
(BBL)
11. OIL
(BBL)
12. WATER
(BBL)
13. GAS
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
311
755
0
121
734
0
3,755
22,739
1 hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Cortney Dyer Title: Production Analyst
Signature: �� Date: 8/17/2017
TOTAL
0
3,755
22,739
Form 10-405 Rev. 04i2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
IHilcorp Alaska, LLC Nikolaevsk August-17
Name of Operator Regulatory Lease I Month and Year of Production
Total Wells
Total Wells Produced
Total Pipeline Runs
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed
Cortney Dyer
Title Production Analyst Date:
0
0
0
0
0 3
TOTAL OIL WATER
9/19/2017
GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
nn n A lm nr -
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC
Nikolaevsk
SEPTEMBER 2017
Name of Operator
Regulatory Lease
Month and Year of Production
Total Wells
1
Total Wells Produced
1
Total Pipeline Runs
0
r
Closing Inventory
0
Opening Inventory
OCT 2 ®2(ii7
0
Other Adjustments
A0GOC,
0
(direct or xylene recovered)
Total Net Production
0
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed CizA&ej' ZC ,*
Cortney Dyer
Title Production Analvst
Date: 10/12/2017
TOTAL
OIL
0
2,945
WATER
GAS
19,6691
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
gn AAr. 9F gin
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
SEPTEMBER 2017
1. Well No.
2. API No.
3. Type
4. Field
5. Method
6. Days in Oper.
7. Avg. FTP
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
50-XXX-XXXXX-XX-XX
(see
& Pool
(see
psig (see
8. OIL
9. WATER
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
(BBL)
(BBL)
I
(BBL)
(BBL)
(BBL)
Red 01
50-231-20021-00-00
2 j
563500
1
30
747
0
98
1656
0
2,945
19,669
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Printed Name: Cortney Dye/r Title: Production Analyst
14.
Signature: c.��LEifl�' Date: 10/12/2017
f
C...... 9n Anc
TOTAL
0
2,945
19,669
11vJ 1 KUI. I IUNJ UN KLVLKSL SIUL Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk OCTOBER 2017
Name of Operator Regulatory Lease Month and Year of Production
Total Wells 1
Total Wells Produced 1
Total Pipeline Runs 0
Closing Inventory
Opening Inventory
Other Adjustments
(direct or xylene recovered)
Total Net Production
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed ''.. �
�lllrla ltnle
Olivia Hunte
Title Production Analyst
Date: 11/1412017
0
0
0
0
0 3,001 19,9731
TOTAL OIL WATER GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
20 AA(' 9s 23n
Name of Operator:
HILCORP ALASKA, LLC
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
OCTOBER 2017
1. Well No.
2. API No.
50-XXX-XXXXX-XX-XX
3. Type
(see
4. Field
& Pool
5. Method
(see
6. Days in Oper.
7. Avg. FTP
psig (see
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
8. OIL
9. WATER
10. GAS
11. OIL
12. WATER
13. GAS
instruct.)
Code
instruct.)
instruct.)
(BBL)
(BBL)
(BBL)
(BBL)
(BBL)
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
31
745
0
97
644
0
3,001
19,973
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Printed Name: Olivia Hunte Title: Production Analyst
14.
Signature: Date: 11/14/2017
TOTAL 10
13,001
119,973
v.- iv- rvv - UY14vw INS 1 RUG I TUNS UN REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk NOVEMBER 2017
Name of Operator Regulatory Lease Month and Year of Production
Total Wells 1
Total Wells Produced 1
Total Pipeline Runs 0
Closing Inventory 0
Opening Inventory 0
Other Adjustments 0
(direct or xylene recovered)
Total Net Production 0
I hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed ultcVez . t7zfe
Olivia Hunte
Title Production Analyst
Date: 12/12/2017
TOTAL
OIL
0
2,728 19,013
WATER GAS
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
20 AAC 25.230
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
NOVEMBER 2017
1. Well No.
2. API No.
50-XXX-XXXXX-XX-XX
3. Type
(see
instruct.)
4. Field
& Pool
Code
5. Method
(see
instruct.)
6. Days in Oper.
7. Avg. FTP
psig (see
instruct.)
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
8. OIL
(BBL)
9. WATER
(BBL)
10. GAS
(BBL)
11. OIL
(BBL)
12. WATER
(BBL)
13. GAS
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
30
739
0
91
634
0
2,728
19,013
I hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Olivia Hunte Title: Production Analyst
/j�r��
Signature: (Milli CL Date: 12/12/2017
TOTAL
10
2,728
119,013
Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
NET OIL SALES
Hilcorp Alaska, LLC Nikolaevsk DECEMBER 2017
Name of Operator Regulatory Lease Month and Year of Production
Total Wells 1
Total Wells Produced 1
Total Pipeline Runs 0
Closing Inventory 0
Opening Inventory 0
Other Adjustments 0
(direct or xylene recovered)
Total Net Production 0
1 hereby certify that the foregoing is true and correct to the best of my knowledge.
Signed �r �«� � f��, 0 2,695 18,926
Olivia Hunte TOTAL OIL WATER GAS
Title Production Analyst Date: 1/15/2018
STATE OF ALASKA
ALASKA OIL AND GAS CONSERVATION COMMISSION
MONTHLY PRODUCTION REPORT
20 AAC 25.230
Name of Operator:
Field and Pool: Nikolaevsk Exploration, Nikolaevsk, Undefined Gas
Month and Year:
HILCORP ALASKA, LLC
DECEMBER 2017
1. Well No.
2. API No.
50-XXX-XXXXX-XX-XX
3. Type
(see
instruct.)
4. Field
& Pool
Code
5. Method
(see
instruct.)
6. Days in Oper.
7. Avg. FTP
psig (see
instruct.)
DAILY AVG. PRODUCTION
TOTAL MONTHLY PRODUCTION
8. OIL
(BBL)
9. WATER
(BBL)
10. GAS
(BBL)
11. OIL
(BBL)
12. WATER
(BBL)
13. GAS
(BBL)
Red 01
50-231-20021-00-00
2
563500
1
29
865
0
93 1653
0
2,695
18,926
1 hereby certify that the foregoing is true and correct to the best of my knowledge.
14.
Printed Name: Olivia Hunte Title: Production Analyst
Signature: cuflZ[ovCI Date: 1/15/2018
TOTAL
10
12,695
118,926
Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate