Request Form To Reduce A Groundwater Certificate

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New (03-2015)
REQUEST TO REDUCE A GROUNDWATER CERTIFICATE
This form may be used to reduce the flow rate, volume, place of use, period of use, and/or purposes of use for
a Groundwater Certificate. Once processed, a new Certificate will be issued for the reduced amount. Once a
new Certificate with the reduced elements is issued, the elements listed on the original Certificate may not be
reinstated. Any right to the use of water under the original Certificate will be permanently relinquished and/or
abandoned in an amount equal to the reduction.
Water Right Owner Names: ________________________________________________________________
Address/City/St/Zip: ______________________________________________________________________
Phone: _____________________
E-mail Address: _____________________________________________
Groundwater Certificate Number: ___________________________________
The reason for this request is: (check one and describe below)
This water right was filed for more water than was actually being used.
A portion of the original right is no longer being used and has been abandoned because:
A shared well user drilled another well and is no longer using this well / water right
The pump was changed to one that pumps at a lower flow rate
Irrigated acreage was reduced
A purpose has been discontinued/reduced (stock removed, pond filled-in (fully or partially), etc.)
Other (explain) _______________________________________________________________
 Yes
 No
Is the flow rate less than identified on the original Groundwater Certificate?
If yes, what is the actual flow rate? _____________ gallons per minute
 Yes
 No
Is the purpose of use less than what is identified in the DNRC water right record?
If yes, please explain—be very specific (i.e. past and current number of irrigated acres, stock, dwellings, etc.).
________________________________________________________________________________________
________________________________________________________________________________________
Provide any additional details that will help DNRC assess this reduction. Note that DNRC will use standard
volumes by purpose (found in ARM 36.12.115) when quantifying the new use. If you are requesting a
departure from those standards, explain that here.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
I declare under penalty of perjury and under the laws of the State of Montana that the foregoing is true and correct.
__________________________________________
__________________________________________
Signature
Date
Signature
Date
State of _________ County of ______________________________
Signed or acknowledged before me on ____________
by _______________________________________
Notary’s Signature _______________________________
Notary’s Name (printed) ___________________________
Notary public for the state of _______________________
Residing at _____________________________________
My commission expires ___________________________
Affix Notarial Seal/Stamp Above
Return form to your local DNRC Water Resources Office or mail to: DNRC / PO Box 201601 / Helena MT 59620

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