Report Forms

Please note that some of these forms can be electronically submitted. In a future website update, each form will have a denotation indicating whether it can be electronically submitted or not.

If you need to fill out a PDF, click here for instructions.

Form Number	Form Type
- Form 1	Application for Permit to Conduct Seismic Exploration
- Form 2	Seismic Exploration Completion Report
- Form 3	Application for Permit to Drill (APD)
- Form	APD Checklist
- Form	Request to Transfer Application or Permit to Drill (APD)
	Well Bonds (Individual and/or Blanket)
- Form 4A	Surety Bond
- Form 4B.1	Certificate of Deposit
- Form 4B.2	Utah State Treasurer's Cash Account
- Form 4B.3	Irrevocable Letter of Credit
- Form 4B.4	Request for Bond Release
	Facility Bonds
- Form 4C	Surety Bond
- Form 4D.1	Certificate of Deposit
- Form 4D.2	Utah State Treasurer's Cash Account
- Form 4D.3	Irrevocable Letter of Credit
	Request for Bond Release
- Bond Release Form	Request for Bond Release
	Surface Owner Protection Act Bonds
- Form 4S.1	Certificate of Deposit
- Form 4S.2	Utah State Treasurer's Cash Account
- Form 5	Designation of Agent or Operator
- Form 6	Entity Action Form
- Form 7	Report of Water Encountered During Drilling
- Form 8	Well Completion or Recompletion Report and Log
- Form 9	Sundry Notices and Reports on Wells
- Form 10	Monthly Oil and Gas Production Report
- Form 11	Monthly Oil and Gas Disposition Report
- Form 12	Report of Transferred Oil
- Form 13A	Summary of Gas Processing Plant Operations
- Form 13B	Gas Processing Plant Product Allocations
- Form 14	Monthly Report of Waste Crude Oil Treatment Facility Operations
- Form 15	Designation of Workover or Recompletion
- Form 15 Procedures	Designation of Workover or Recompletion -- Procedures For Submitting Application
	UIC Forms
- UIC Form 1	Application for Injection Well
- UIC Form 2 (part 1)	Monthly Report of Enhanced Recovery Project
- UIC Form 2 (part 2)	Monthly Report of Enhanced Recovery Project
- UIC Form 3	Monthly Injection Report
- UIC Form 4	Annual Fluid Injection Report
- UIC Form 5	Transfer of Authority to Inject
- UIC Form 6	Injection Well - Pressure Test
	Other
- Incident Report eForm	Incident Report Electronic Web Form        (Click here for reporting Guidelines)
- ePermit Registration	ePermit Registration Form (for electronic permit & report submittal) This registration form may now be submitted by email to rachelmedina@utah.gov. Please follow up with notarized paper form.
- Waste Facilty Report	E & P Waste Facility Quarterly Report