Report And Permit Forms

(1) The report and permit forms designated below may be obtained from the State Oil and Gas Board, 401 Church St., Nashville, TN 37243-1534, and are hereby adopted and made a part of the rules set out in Chapter 1040-01-01 through Chapter 1040-07-01: (a) Application to Amend Well Permit (Form P-AD-2) (b) Application to Change Operators (Form P-AD-3) (c) Application for Permit to Drill (Form P-AD-1) (d) Authority to Drill, Deepen, or Reopen a Well (Form P) (e) Gas Well Deliverability Tests (Form R-DT-1) (f) Monthly Gatherer’s and/or Transporter’s Natural Gas Report (Form R-MP-5) (g) Organization Report (Form R-O-1) (h) Periodic GPM Test Report (Form R-GPM-1) (i) Plug and Abandon Report (Form R-P&A-1) (j) Pooling Affidavit (Form PA) (k) Pressure Maintenance and Secondary Recovery Questionnaire (Form Q-PMSR) (l) Statement of No Objection to Proposed Surface Disturbance (Form NO) (m) Surface Owners Notification Certification (Form NC) (n) Transporter’s and Storer’s Monthly Report for Crude Oil and/or Condensate (Form R- MP-2) (o) Well History, Work Summary, And Completion or Recompletion Report (Form R-WH-1) (p) Irrevocable Standby Letter of Credit Format (Form ILC)