CERTIFICATE OF COMPLIANCE
RAILROAD COMMISSION OF TEXAS
RAILROAD COMMISSION OF TEXAS
P-4
Oil and Gas Division
AND TRANSPORTATION AUTHORITY
Oil and Gas Division
PO Box 12967
5/02—
Austin TX
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78711-2967
1.
2. Lease name as shown on proration schedule
Field name exactly as shown on proration schedule
3. Current operator name exactly as shown on P-5 Organization Report
4. Operator P-5 no.
5. Oil Lse/Gas ID no.
6. County
7. RRC district
8. Operator address including city, state, and zip code
9. Well no(s) (see instruction E)
10. Classification
11. Effective Date
Oil
Gas
Other (see instruction A)
12. Purpose of Filing. (Complete section a or b below.) (See instructions B and G)
a. Change of:
operator
oil or condensate gatherer
gas gatherer
gas purchaser
gas purchaser system code
field name from: ____________________________________________________________________________________
lease name from: ____________________________________________________________________________________
OR
b. New RRC Number for:
oil lease
gas well
Due to:
new completion or recompletion
reclass oil to gas
reclass gas to oil
other well (specify)__________________
consolidation, unitization, or subdivision (oil lease only)
13. Authorized GAS WELL GAS or CASINGHEAD GAS Gatherer(s) and/or Purchaser(s). (See instruction G).
Purchaser’s
Percent of
Name of GAS WELL GAS or CASINGHEAD GAS
RRC
Take
Gatherer(s) or Purchaser(s) As Indicated in Columns to the Left
Assigned
(Attach an additional sheet in same format if more space is needed)
System Code
14. Authorized OIL or CONDENSATE Gatherer(s). (See instruction G).
RRC USE ONLY
Name of OIL or CONDENSATE Gatherer(s) - List Highest Volume Gatherer First
Percent of
Reviewer’s initials: _________
(Attach an additional sheet in same format if more space is needed)
Take
Approval date: ____________
15. PREVIOUS OPERATOR CERTIFICATION FOR CHANGE OF OPERATOR P-4 FILING. Being the PREVIOUS OPERATOR, I certify that operating
responsibility for the well(s) designated in this filing, located on the subject lease has been transferred in its entirety to the above named Current Operator. I understand, as
Previous Operator, that designation of the above named operator as Current Operator is not effective until this certificate is approved by the Commission.
___________________________________________________________
___________________________________________________________________
Name of Previous Operator
Signature
Authorized Employee
Authorized agent of previous
___________________________________________________________
of previous operator
operator (see instruction G)
Name (print)
___________________________________________________________
__________________________________
____________________________
Title
Date
Phone with area code
16. CURRENT OPERATOR CERTIFICATION. By signing this certificate as the Current Operator, I certify that all statements on this form are true and correct and
I acknowledge responsibility for the regulatory compliance of the subject lease including plugging of well(s) pursuant to Rule 14. I further acknowledge that I assume
responsibility for the physical operation, control, and proper plugging of each well designated in this filing. I also acknowledge that I will remain designated as the
Current Operator until a new certificate designating a new Current Operator is approved by the Commission.
___________________________________________________________
___________________________________________________________________
Name (print)
Signature
___________________________________________________________
Authorized Employee
Authorized agent of current
Title
of current operator
operator (see instruction G)
___________________________________________________________
__________________________________
____________________________
E-mail Address (optional)
Date
Phone with area code
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