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AOGC Forms and Documents

Listed below are forms, documents, and reports as required by the Arkansas Oil and Gas Commission General Rules and Regulations. If more specific information is required, please call the Director's Office at 501-683-5814 and we'd be happy to assist you.

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Form NameNumberRevisedPDFXLS
Bond  07-25-2008PDF-
Irrevocable%20Letter%20of%20Credit  07-25-2008PDF-
Incident Report – Gas Transmission and Gathering Systems F7100201-01-2002PDF-
Certificate of Compliance- Statewide Rule B-41 HS-104-01-2009PDF-
Organization Report 111-01-2014PDFExcel
Severance Tax Producer Registration 1A11-01-2010PDFExcel
Application for a Permit to Drill 206-01-2011PDFExcel
Notice of Intention to Construct Drilling & Reserve Pits 2A09-01-2011PDFExcel
Notice of Closure for Drilling & Reserve Pits 2B09-01-2011PDFExcel
Producer's Well Completion and Recompletion Report 304-01-2009PDFExcel
Well Fracture Stimulation Report 3A01-01-2011PDFExcel
Request for Certificate of Compliance or Change of Purchaser 403-01-2009PDFExcel
Notice of Commencement of Production 4A03-01-2009PDFExcel
Application For Administrative Location Exception 502-01-2011PDFExcel
Producer's Monthly Oil Report 604-01-2009PDFExcel
Producer's Monthly Brine Water Report 6B06-01-2017PDFExcel
Monthly Gas Sales Report 711-01-2017PDFExcel
Gasoline or Other Extraction Plant Monthly Report - Sheet 1 8A02-01-2016PDFExcel
Gasoline or Other Extraction Plant Monthly Report - Sheet 2 8B02-01-2016PDFExcel
Transporter's and Storer's Monthly Report - Sheet 1 9A02-01-2016PDFExcel
Transporter's and Storer's Monthly Report - Sheet 2 9B02-01-2016PDFExcel
Transporter's and Storer's Monthly Report - Sheet 3 9C02-01-2016PDFExcel
Transporter's and Storer's Monthly Report - Sheet 4 9D02-01-2016PDFExcel
Transporter's and Storer's Monthly Report - Sheet 5 9E02-01-2016PDFExcel
Refiner's Monthly Report - Sheet 1 10A02-01-2016PDFExcel
Refiner's Monthly Report - Sheet 2 10B02-01-2016PDFExcel
Refiner's Monthly Report - Sheet 3 10C02-01-2016PDFExcel
Refiner's Monthly Report - Sheet 4 10D02-01-2016PDFExcel
Notice of Intent to Plug 1107-01-2010PDFExcel
Dry Natural Gas Well Test 1308-01-2014PDFExcel
Monthly Class II Well Disposal Report 1402-01-2016PDFExcel
Monthly Class II Commercial Well Disposal Report 14A02-01-2016PDFExcel
Monthly Class II Well Disposal Report - B-43 Area Only 14B02-01-2016PDFExcel
Monthly Class V Brine Injection Well Report 14C06-01-2017PDFExcel
Notice of Tank Cleaning 1512-28-2016PDFExcel
Monthly Report and Operations Statement for Reclaiming and Treating Plants 1601-31-2018PDFExcel
Receipts By Field, By Leases - Sheet A 16A01-31-2018PDFExcel
Application to Measure Gas Off Lease 1704-01-2009PDFExcel
Report of Unit Operations 1804-01-2009PDFExcel
Report of Gas Storage Unit Operations 18GS12-01-2016PDFExcel
Application for Permit to Conduct Seismic Operations 1904-01-2009PDFExcel
Permit to Conduct Seismic Operatins 19A04-01-2009PDFExcel
Seismic Bond 19B04-01-2009PDFExcel
Request For Disposal of Reserve Pit Fluids 2004-01-2009PDFExcel
North Arkansas Gas Field Commingle Request Form 2104-01-2012PDFExcel
North Arkansas Gas Field Additional Completion Request Form 2209-01-2006PDFExcel
Notification of Well Transfer or Name Change 2312-05-2018PDFExcel
Notification of Fire, Spill, Discharges, Blow-out, or Failure of Production Equipment Incident Report 2402-20-2020PDFExcel
Application for Wells that Encroach On or Cross Drilling Unit Boundaries as Authorized by General Rules B-43 & B-44 2501-01-2012PDFExcel
Application to Construct and Operate a Natural Gas Pipeline System & Annual Report 2604-01-2009PDFExcel
Notice of Construction and/or Repair of a Natural Gas Pipeline System 2704-01-2009PDFExcel
Notification of Natural Gas Pipeline Incident Report 2804-01-2009PDFExcel
North Arkansas Gas Field - Request To Produce Dry Gas Up Annular Space Between Production and Surface Casing 2910-01-2008PDFExcel
Operator Request For Certification of Eligibilty For Severance Tax Benefits for Crude Oil Production 3004-01-2009PDFExcel
Operator Request For Natural Gas Well Category Determination For Severance Tax Purposes 3104-01-2009PDFExcel
Request For Exploration And Production Fluid Transportation System Permit 3204-01-2009PDFExcel
Application For Temporary Abandoned Well Status 3312-05-2018PDFExcel
General Rule B-43: Application For a Well Location That Crosses or Encroaches Upon Another Well 34A10-01-2015PDFExcel
General Rule B-44: Application For a Well Location Closer Than 560 Feet For Middle Atoka Completions 34B10-01-2015PDFExcel
Application For Conversion of a Permitted Well to Domestic Use 3505-01-2011PDFExcel
Class II UIC Injection Well Permit Application 3612-05-2018PDFExcel
Class II UIC Injection Well Permit Amendment 36A06-01-2014PDFExcel
Class V Spent Brine Injection Well Permit Application 36B07-01-2015PDFExcel
Claim of Entitlement to Withhold the Identity of a Chemical Constituent as a Trade Secret or Request for Trade Secret Exemption 3712-01-2011PDFExcel
Notification of Well Servicing 3802-01-2012PDFExcel
General Rule B-19 Casing and Cementing Program Report 3904-01-2012PDFExcel
Operator Request to Place a Vacuum on an Oil and/or Gas Producing Stratum 4005-01-2012PDFExcel
Notification of Compliance with General Rule D-22 Requirement for New Lease Rights Gas Supply Lines 41A07-24-2015PDFExcel
Notification of Compliance with General Rule D-22 Requirement for Existing Lease Rights Gas Supply Lines 41B07-24-2015PDFExcel

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5301 Northshore Drive,
North Little Rock, AR 72118
Phone: 501-683-5814