Request To Add Drilling Or Well Servicing Equipment To Operator License printable pdf download

Request To Add Drilling Or Well Servicing Equipment To Operator License

KANSAS CORPORATION COMMISSION

OIL & GAS CONSERVATION DIVISION

LICENSE DEPARTMENT

REQUEST

TO ADD DRILLING OR WELL SERVICING EQUIPMENT

TO OPERATOR LICENSE

To obtain authority to operate drilling or well servicing equipment under the provisions

of the laws of Kansas, KSA 55-155, please complete the following and provide the

required fees and documentation.

DATE_______________

Company/Individual _______________________________ Phone (__)_________

Address__________________________________________

City/State/Zip_____________________________________

KCC License #_________

Expiration date of License_________

Please complete the following information for all equipment being licensed. *

YEAR

MAKE

MODEL

TYPE OF EQUIPMENT

*Kansas taxed Licensee: Attach a copy of equipment assessment rendition sheets

and paid personal property tax receipts or a Bill of Sale.

Remittance enclosed: $25.00 per equipment tag = $_____________

Mail to: KCC – Conservation Division, Licensing Department, 266 N Main St,

Ste 220, Wichita, KS 67202-1513

Phone: (316) 337-6194

Request To Add Drilling Or Well Servicing Equipment To Operator License