Get ONRR-4054-A 2013

OMB Control Number 1012-0004 OMB Approval Expires 12/31/2015 U.S. DEPARTMENT OF THE INTERIOR Office of Natural Resources Revenue OIL AND GAS OPERATIONS REPORT PART A - WELL PRODUCTION OGOR-A REPORTER USE REPORT TYPE ORIGINAL MODIFY DELETE/ADD BY LINE ONRR LEASE/AGREEMENT NUMBER 11 REPLACE OVERLAY PREVIOUS REPORT PRODUCTION MONTH 6 MMCCYY ONRR OPERATOR NUMBER 5 OPERATOR NAME 30 OPERATOR LEASE/AGREEMENT NUMBER 20 OPERATOR WELL NUMBER WELL STATUS CODE DAYS PRODUCED 2 SIDETRACK PRODUCING INTERVAL LINE NUMBER ACTION CODE 1 SEQUENCE ONRR USE AGENCY LEASE/AGREEMENT NUMBER 25 OR STATE COUNTY INDIAN PRODUCTION VOLUMES GAS MCF OIL/CONDENSATE BBL WATER INJECTION VOLUME BBL/MCF TOTAL PRODUCTION 9 TOTAL INJECTION 9 CONTACT NAME First M. I. Last TELEPHONE NUMBER 10 AUTHORIZING SIGNATURE FORM ONRR-4054-A Rev* 6/2013 DATE 8 MMDDCCYY EXTENSION NUMBER 5 - COMMENTS 60 PAGE OF INSTRUCTIONS WHO MUST FILE A separate report must be filed monthly unless non-monthly reporting has been approved by each designated operator of an offshore OCS onshore or Indian lease/agreement that contains active wells. Wells must be reported from the time active drilling is concluded and up until the status is changed to permanently abandoned or until inventory has been disposed of* WHEN TO FILE Reports must be received by the 15th of the second month following the production month e*g* the report for June is due on August 15. You are required to report electronically under 30 CFR 1210 2012 formerly 30 CFR 210 unless ONRR approved you to report on paper. PO Box 25627 Denver CO 80225-0627 REFER TO THE PRODUCTION REPORTER HANDBOOK PRIOR TO COMPLETING THIS FORM. The Paperwork Reduction Act of 1995 PRA Statement The PRA 44 U*S*C. 3501 et seq. requires us to inform you that we collect this information to corroborate oil and gas production and disposition data with sales and royalty data* Responses are mandatory 43 U*S*C. 1334. Proprietary information is protected in accordance with the standards established by the Federal Oil and Gas Royalty Management Act of 1982 30 U*S*C. 1733 the Freedom of Information Act 5 U*S*C. 552 b 4 and the Department regulations 43 CFR 2. An agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Public reporting burden for this form is estimated at an average of 5 minutes/hour per report for electronic and manual reporting including the time for reviewing instructions gathering and maintaining data and completing and reviewing the form* Direct your comments regarding the burden estimate or any other aspect of this form to the Office of Natural Resources Revenue Attention Rules Regs Team MS 61030A PO Box 25165 Denver CO 80225-0165. I. Last TELEPHONE NUMBER 10 AUTHORIZING SIGNATURE FORM ONRR-4054-A Rev* 6/2013 DATE 8 MMDDCCYY EXTENSION NUMBER 5 - COMMENTS 60 PAGE OF INSTRUCTIONS WHO MUST FILE A separate report must be filed monthly unless non-monthly reporting has been approved by each designated operator of an offshore OCS onshore or Indian lease/agreement that contains active wells. Wells must be reported from the time active drilling is concluded and up until the status is changed to permanently abandoned or until inventory has been disposed of* WHEN TO FILE Reports must be received by the 15th of the second month following the production month e*g* the report for June is due on August 15. .