Form P-5 Organization Report - Railroad Commission Of Texas printable pdf download

RAILROAD COMMISSION OF TEXAS

FORM P-5

ORGANIZATION

Oil and Gas Division

REPORT

READ INSTRUCTIONS ON BACK

(Rev. 09/2011)

Purpose of Filing

New Filing

Annual Refiling

2. RRC Operator

No. (if assigned)

Change of Officers/Resident Agent

Address Correction

Name of entity:

(If the name of the organization has changed, see Instructions on back)

Mailing Address:

Street Address:

Organization Phone Number:

Emergency (after hours) Phone Number:

4. Plan of Organization

A. Corporation

B. Limited Partnership

C. Sole Proprietorship

D. Partnership

E. Trust

(select one)

F. Joint Venture

G. Estate

H. Ltd Liability Co. (LLC)

I. Other (specify):

Name of Texas Resident Agent:

Street Address

Mailing Address

A Texas Resident Agent is required for any foreign or nonresident organization pursuant to Statewide Rule 1(a)(4)(D).

6. Attachments:

P-5O - Officer Listings:

Information for each controlling entity of the organization as required by Statewide Rule 1(a)(4)(C).

(optional) - Designation of non-employee agents authorized to sign certain Forms P-4 and P-5 pursuant to Statewide Rule 1(a)(4)(E).

P-5A - Agent Listings:

Required for all "New Filing" and "Annual Refiling" submissions. See instructions on back.

Filing Fee

If the operator is required to maintain financial assurance, the Organization Report will not be approved until it is in place.

Financial Assurance

7. Reorganization

Check here if this is a reorganization of an existing registrant.

If checked, provide the current name and RRC P5 Number:

8. Comments: (optional)

Organization reports for operators of inactive wells: The Commission may not approve the P-5 Organization Report for an operator of one or more inactive wells unless the

operator has complied with Commission rules and Texas statutes concerning the approval of plugging extensions for such inactive wells, including disconnection of electrical

service and any required surface equipment removal.

Organization reports for operators with outstanding enforcement orders/judgments: The Commission may not approve the P-5 Organization Report for an operator if that

operator is the subject of a final and unappealable order related to a violation of a Commission rule, order, license, permit, or certificate relating to safety or the prevention or

control of pollution. Organization Reports for organizations with officers who are subject to such outstanding orders through their involvement with other organizations similarly

may not be approved.

If the organization has used, or reported use of, a well for which the Certificate of Compliance has been canceled, the Commission may refuse to approve an Organization

Report until the operator has paid any requried reconnect fees and the Certificate of Compliance has been reissued for the well.

An organization must file an amended Organization Report within 15 days after a change in any information required to be reported in the Organization Report.

FOR RRC USE ONLY

Approved by

Signature

Title

(

)

Remarks

Filer's Name (Printed)

Filer's Telephone Number

Email Address (OPTIONAL - SEE INSTRUCTIONS FOR IMPORTANT INFORMATION)

Date

Certificate: I declare under penalties prescribed in Sec. 91.143, Texas Natural Resources Code, that I am