Manitoba
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Manitoba Science, Technology, Energy and Mines

Forms

Gold dotApplication and Registration
Gold dotRehabilitation
Gold dotCertificate of Abandonment


Please submit forms to appropriate office

Gold dotGeophysical
Gold dotProduction, Crown Royalty and Freehold Tax
Gold dotCrown Oil and Gas Land Administration

Application and Registration Forms

Application To: (Abandon, Deepen, Suspend, etc.) Microsoft Word PDF
Application for a Flow Line License  Microsoft Word PDF
Equipment Registration Microsoft Word PDF
Well License Microsoft Word PDF
Consent of Occupant Microsoft Word PDF
Transfer of Well License - Schedule B (Drilling and Production Regulation) Microsoft Word PDF
New Well Summary - Vertical Well Microsoft Word PDF
New Well Summary - Horizontal Well Microsoft Word PDF
Well Deepening Re-entry Summary Microsoft Word PDF

Rehabilitation and Certificate of Abandonment Forms

Acknowledgement of Restoration
Notice 03-01Abandonment, Restoration and Rehabilitation ProceduresPDF

Microsoft Word PDF
Application for Certificate of Abandonment Microsoft Word PDF
Company Rehab. Submission Form  Microsoft Word PDF

Geophysical Forms

Application for Geophysical License Microsoft Word PDF
Report on Flowing Shot Hole Microsoft Word PDF
Report on Unexploded Charges Microsoft Word PDF

Production, Crown Royalty and Freehold Tax Forms

Monthly Oil and Gas Production Report and Crown Royalty Statement Microsoft Word PDF

Non-Unit Sample

Microsoft Word PDF

Unit Sample

Microsoft Word PDF
Monthly Freehold Oil and Gas Production Tax Microsoft Word PDF

Non-Unit Sample

Microsoft Word PDF

Unit Sample

Microsoft Word PDF
*Initial Injection / Disposal Report Microsoft Word PDF
*Initial Production Report   PDF
Salt Water Disposal Report Excel

Crown Oil and Gas Land Administration Forms

Schedules originate from the Crown Disposition Regulation

Exploration Reservation - Schedule B   PDF
Oil and Gas Lease - Schedule C   PDF
Transfer of Disposition - Schedule D Microsoft Word PDF
Transfer of an Undivided Interest in a Disposition - Schedule E Microsoft Word PDF
Transfer of Part of Lease Area - Schedule F Microsoft Word PDF
Notice of Instrument - Schedule G Microsoft Word PDF
Discharge of Instrument - Schedule H Microsoft Word PDF

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