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Petroleum

Forms

The following forms require either Microsoft Word or Acrobat Reader. You may download these programs by clicking on http://www.gov.mb.ca/example/utilities.html.  Please use Microsoft Word to complete and submit your forms. The forms with the * may be submitted as an attachment to petropub@gov.mb.ca. Then, click on the file name to open the document. You may then view, print, complete and submit them by mail or fax to:

Science, Technology, Energy and Mines
Petroleum Branch
Box 1359
227 King Street West
Virden MB R0M 2C0
Phone: 204-748-4260
or Fax: 204-748-2208 

Microsoft WordMicrosoft Word
Adobe Acrobat Reader Acrobat Reader


Application and Registration Forms
Application To: (Abandon, Deepen, Suspend, etc.) Microsoft Word Adobe Acrobat Reader
Application for a Flow Line License  Microsoft Word Adobe Acrobat Reader
Equipment Registration Microsoft Word Adobe Acrobat Reader
Well License Microsoft Word Adobe Acrobat Reader
Consent of Occupant Microsoft Word Adobe Acrobat Reader
Transfer of Well License Microsoft Word Adobe Acrobat Reader
New Well Summary - Vertical Well Microsoft Word Adobe Acrobat Reader
New Well Summary - Horizontal Well Microsoft Word Adobe Acrobat Reader
Well Deepening Re-entry Summary Microsoft Word Adobe Acrobat Reader


Rehabilitation and Certificate of Abandonment Forms
Acknowledgement of Restoration

Abandonment, Restoration and Rehabilitation ProceduresMicrosoft Word
Abandonment, Restoration and Rehabilitation Procedures Adobe Acrobat Reader
 		 Microsoft Word Adobe Acrobat Reader
Application for Certificate of Abandonment Microsoft Word Adobe Acrobat Reader
Company Rehab. Submission Form  Microsoft Word Adobe Acrobat Reader


Geophysical Forms
Application for Geophysical License Microsoft Word Adobe Acrobat Reader
Report on Flowing Shot Hole New Microsoft Word Adobe Acrobat Reader
Report on Unexploded Charges New Microsoft Word Adobe Acrobat Reader

Production, Crown Royalty and Freehold Tax Forms
Monthly Oil and Gas Production Report and Crown Royalty Statement Microsoft Word Adobe Acrobat Reader
          Non-Unit Sample Microsoft Word Adobe Acrobat Reader
          Unit Sample Microsoft Word Adobe Acrobat Reader
Monthly Freehold Oil and Gas Production Tax Microsoft Word Adobe Acrobat Reader
          Non-Unit Sample Microsoft Word Adobe Acrobat Reader
          Unit Sample Microsoft Word Adobe Acrobat Reader
*Initial Injection / Disposal Report Microsoft Word Adobe Acrobat Reader
*Initial Production Report Microsoft Word Adobe Acrobat Reader
Salt Water Disposal Report  

Crown Oil and Gas Land Administration Forms
Transfer of Disposition Microsoft Word Adobe Acrobat Reader
Transfer of an Undivided Interest in a Disposition Microsoft Word Adobe Acrobat Reader
Transfer of Part of Lease Area Microsoft Word Adobe Acrobat Reader
Notice of Instrument Microsoft Word Adobe Acrobat Reader
Discharge of Instrument Microsoft Word Adobe Acrobat Reader

   
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