Form C-102 "Well Location and Acreage Dedication Plat" - New Mexico

What Is Form C-102?

This is a legal form that was released by the New Mexico Energy, Minerals and Natural Resources Department - a government authority operating within New Mexico. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on August 1, 2011;
  • The latest edition provided by the New Mexico Energy, Minerals and Natural Resources Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form C-102 by clicking the link below or browse more documents and templates provided by the New Mexico Energy, Minerals and Natural Resources Department.

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District I
State of New Mexico
Form C-102
1625 N. French Dr., Hobbs, NM 88240
Revised August 1, 2011
Phone: (575) 393-6161 Fax: (575) 393-0720
Energy, Minerals & Natural Resources Department
District II
Submit one copy to appropriate
811 S. First St., Artesia, NM 88210
OIL CONSERVATION DIVISION
Phone: (575) 748-1283 Fax: (575) 748-9720
District Office
District III
1220 South St. Francis Dr.
1000 Rio Brazos Road, Aztec, NM 87410
Phone: (505) 334-6178 Fax: (505) 334-6170
AMENDED REPORT
Santa Fe, NM 87505
District IV
1220 S. St. Francis Dr., Santa Fe, NM 87505
Phone: (505) 476-3460 Fax: (505) 476-3462
WELL LOCATION AND ACREAGE DEDICATION PLAT
1
2
3
API Number
Pool Code
Pool Name
4
5
6
Property Code
Property Name
Well Number
7
8
9
OGRID No.
Operator Name
Elevation
Surface Location
10
UL or lot no.
Section Township
Range
Lot Idn
Feet from the
North/South line
Feet from the
East/West line
County
Bottom Hole Location If Different From Surface
11
UL or lot no.
Section Township
Range
Lot Idn
Feet from the
North/South line
Feet from the
East/West line
County
12
13
14
15
Dedicated Acres
Joint or Infill
Consolidation Code
Order No.
No allowable will be assigned to this completion until all interests have been consolidated or a non-standard unit has been approved by the
division.
16
OPERATOR CERTIFICATION
17
I hereby certify that the information contained herein is true and complete
to the best of my knowledge and belief, and that this organization either
owns a working interest or unleased mineral interest in the land including
the proposed bottom hole location or has a right to drill this well at this
location pursuant to a contract with an owner of such a mineral or working
interest, or to a voluntary pooling agreement or a compulsory pooling
order heretofore entered by the division.
Signature
Date
Printed Name
E-mail Address
SURVEYOR CERTIFICATION
18
I hereby certify that the well location shown on this
plat was plotted from field notes of actual surveys
made by me or under my supervision, and that the
same is true and correct to the best of my belief.
Date of Survey
Signature and Seal of Professional Surveyor:
Certificate Number
District I
State of New Mexico
Form C-102
1625 N. French Dr., Hobbs, NM 88240
Revised August 1, 2011
Phone: (575) 393-6161 Fax: (575) 393-0720
Energy, Minerals & Natural Resources Department
District II
Submit one copy to appropriate
811 S. First St., Artesia, NM 88210
OIL CONSERVATION DIVISION
Phone: (575) 748-1283 Fax: (575) 748-9720
District Office
District III
1220 South St. Francis Dr.
1000 Rio Brazos Road, Aztec, NM 87410
Phone: (505) 334-6178 Fax: (505) 334-6170
AMENDED REPORT
Santa Fe, NM 87505
District IV
1220 S. St. Francis Dr., Santa Fe, NM 87505
Phone: (505) 476-3460 Fax: (505) 476-3462
WELL LOCATION AND ACREAGE DEDICATION PLAT
1
2
3
API Number
Pool Code
Pool Name
4
5
6
Property Code
Property Name
Well Number
7
8
9
OGRID No.
Operator Name
Elevation
Surface Location
10
UL or lot no.
Section Township
Range
Lot Idn
Feet from the
North/South line
Feet from the
East/West line
County
Bottom Hole Location If Different From Surface
11
UL or lot no.
Section Township
Range
Lot Idn
Feet from the
North/South line
Feet from the
East/West line
County
12
13
14
15
Dedicated Acres
Joint or Infill
Consolidation Code
Order No.
No allowable will be assigned to this completion until all interests have been consolidated or a non-standard unit has been approved by the
division.
16
OPERATOR CERTIFICATION
17
I hereby certify that the information contained herein is true and complete
to the best of my knowledge and belief, and that this organization either
owns a working interest or unleased mineral interest in the land including
the proposed bottom hole location or has a right to drill this well at this
location pursuant to a contract with an owner of such a mineral or working
interest, or to a voluntary pooling agreement or a compulsory pooling
order heretofore entered by the division.
Signature
Date
Printed Name
E-mail Address
SURVEYOR CERTIFICATION
18
I hereby certify that the well location shown on this
plat was plotted from field notes of actual surveys
made by me or under my supervision, and that the
same is true and correct to the best of my belief.
Date of Survey
Signature and Seal of Professional Surveyor:
Certificate Number