Get Dwr Form 55 71a Fill In Form

This guide provides clear instructions for completing the DWR Form 55-71A, titled 'Request to Change Well Information.' Follow these steps to ensure you fill out the form accurately and efficiently, whether you are changing well ownership, updating contractor information, or modifying well details.

Follow the steps to effectively complete the DWR Form 55-71A online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor. This action will allow you to access the form for further completion.
2. In the upper right-hand corner, enter the well registration number assigned to your well by the Arizona Department of Water Resources (ADWR). This is essential for identifying your well in their records.
3. Fill out Section 1 with the well owner's information. Include the name, mailing address, and phone and fax numbers. If the owner is an organization, specify a contact person.
4. Provide the location of the well. Include the street address, legal description (township, range, section, etc.), latitude and longitude (if available in degrees-minutes-seconds), the county tax assessor’s parcel identification number, and the county name.
5. In Section 1, check the appropriate box for the type of request you are making: change of well drilling contractor, change of well ownership, or change of well information.
6. If you are changing the well drilling contractor, complete Section 2 with details about the current contractor and the new contractor, including names, contact information, and license details.
7. If you are reporting a change in ownership, complete Section 3 with details about the previous and new owners, providing their names and contact information.
8. For changes in well information, fill in Section 4 with a clear explanation of the changes. Attach any additional documents that clarify these changes, such as maps or diagrams.
9. If applicable, Section 5 allows the property owner and well owner to grant ADWR permission to access the property for water measurements.
10. Finally, sign and date the form in Section 6. Make sure to review the form for clarity and completeness.
11. Submit the completed form either by mailing it to the ADWR or delivering it in person to their office. Ensure all required fees are enclosed, as forms without payment will be returned.

Complete your documents online today to ensure timely and accurate processing.