Forms For The Oil, Gas And Solution Salt Mining Regulatory Program
The Division of Mineral Resources is now accepting electronic signatures (eSignatures) on most forms. Instructions for creating a verifiable eSignature can be found on the Adobe website (link leaves DEC website). Any form containing an electronic signature must be submitted via email to DEC and cannot be printed and mailed.
The forms below apply to both applicants and current operators of all well types regulated under Article 23 of the Environmental Conservation Law, titled the "Oil, Gas and Solution mining law." The title of the law however, does not represent the complete list of well types regulated by the Division of Mineral Resources.
Registrations and Authorizations
- Application for API Well Identification Number and instructions (PDF) (297 KB, Legal paper size)
- Registration to File Electronic Submission Form (PDF) (90 KB)
- Organizational Report (PDF) (301 KB)
Financial Security for Wells
- Financial Security Worksheet (PDF) (196 KB)
- Well Plugging and Surface Restoration Surety Bond (PDF) (200 KB)
- Well Plugging and Surface Restoration Surety Bond Rider (PDF) (204 KB)
- Irrevocable Letter of Credit (PDF) (16 KB)
- Irrevocable Letter of Credit (Word) (30 KB)
- Irrevocable Letter of Credit Amendment (PDF) (189 KB)
- Irrevocable Letter of Credit Amendment (Word) (35 KB)
- Assignment of Certificate of Deposit (PDF) (15 KB)
- Assignment of Certificate of Deposit (Word) (28 KB)
- Certificate of Deposit Amendment (PDF) (190 KB)
- Certificate of Deposit Amendment (Word) (34 KB)
A detailed description about Financial Security requirements and forms can be found at the Financial Security Information page.
Well Drilling and Completion
- Application for Permit to Drill, Deepen, Plug Back or Convert a Well (PDF) (355 KB, Legal paper size) and instructions (PDF) (126 KB)
- Applicant's Checklist for Spacing Unit Map (PDF) (52 KB) for wells subject to ECL Section 23-0501
- Environmental Assessment Form (EAF) (PDF) (316 KB) for well permitting - this form must be submitted as part of every application
- Full Environmental Assessment Form (FEAF) - use of this form is based on site-specific circumstances, only if directed
- Request for BOP Equipment Waiver (PDF) (220 KB)
- Application for Approval to Flare (PDF) (371 KB, Legal paper size)
- Well Drilling and Completion Report (PDF) (383 KB, Legal paper size) and instructions (PDF) (130 KB)
Spacing and Compulsory Integration
- Affirmation of Acreage Control and Rights in Target Formation (PDF) (198 KB) for wells subject to ECL Section 23-0501
- Application for Non-Conforming Spacing Unit or Variance From Regulatory Well Spacing (PDF) (236 KB)
- Compulsory Integration Election Form (PDF) (265 KB)
Annual Reports
- Annual Well Report and instructions (PDF) (1.6 MB)
- Gas Purchaser Annual Report (PDF) (256 KB)
- Oil Purchaser Annual Report (PDF) (254 KB)
Shut-In or Temporary Abandonment
Transfer of Well Responsibilities
- Request for Transfer of Well Responsibilities (PDF) (1.2 MB, Legal paper size)
Non-Routine Incidents
- Non-Routine Incident Report (PDF) (283 KB)
Well Plugging
- Notice of Intention to Plug and Abandon (PDF) (500 KB, Legal size paper) and instructions (PDF) (265 KB)
- Plugging Report (PDF) (157 KB, Legal paper size) and instructions (PDF) (141 KB)
Underground Gas Storage
- Application for Transfer of Underground Storage Permit (PDF) (222 KB, Legal size paper) and instructions (PDF) (136 KB)
Division of Air Part 203 Forms for Oil and Natural Gas Sector
- Part 203 Forms for Oil and Natural Gas Sector - one-time baseline report
For more information on the Part 203 regulations and one-time baseline report required for oil and natural gas operators, visit the Division of Air web page on Controlling Air Pollution from Facilities.
DMN, Bureau of Oil and Gas Regulation
625 Broadway
Albany, NY 12233
