Form C-103 "Sundry Notices and Reports on Wells" - New Mexico

What Is Form C-103?

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. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 18, 2013;
  • 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-103 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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Download Form C-103 "Sundry Notices and Reports on Wells" - New Mexico

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Submit 1 Copy To Appropriate District
State of New Mexico
Form C-103
Office
Revised July 18, 2013
Energy, Minerals and Natural Resources
District I – (575) 393-6161
WELL API NO.
1625 N. French Dr., Hobbs, NM 88240
District II – (575) 748-1283
OIL CONSERVATION DIVISION
811 S. First St., Artesia, NM 88210
5. Indicate Type of Lease
District III – (505) 334-6178
1220 South St. Francis Dr.
STATE
FEE
1000 Rio Brazos Rd., Aztec, NM 87410
Santa Fe, NM 87505
District IV – (505) 476-3460
6. State Oil & Gas Lease No.
1220 S. St. Francis Dr., Santa Fe, NM
87505
SUNDRY NOTICES AND REPORTS ON WELLS
7. Lease Name or Unit Agreement Name
(DO NOT USE THIS FORM FOR PROPOSALS TO DRILL OR TO DEEPEN OR PLUG BACK TO A
DIFFERENT RESERVOIR. USE "APPLICATION FOR PERMIT" (FORM C-101) FOR SUCH
PROPOSALS.)
8. Well Number
1. Type of Well: Oil Well
Gas Well
Other
2. Name of Operator
9. OGRID Number
3. Address of Operator
10. Pool name or Wildcat
4. Well Location
Unit Letter___________:__________feet from the _____________ line and _____________feet from the ____________line
Section
Township
Range
NMPM
County
11. Elevation (Show whether DR, RKB, RT, GR, etc.)
12. Check Appropriate Box to Indicate Nature of Notice, Report or Other Data
NOTICE OF INTENTION TO:
SUBSEQUENT REPORT OF:
PERFORM REMEDIAL WORK
PLUG AND ABANDON
REMEDIAL WORK
ALTERING CASING
TEMPORARILY ABANDON
CHANGE PLANS
COMMENCE DRILLING OPNS.
P AND A
PULL OR ALTER CASING
MULTIPLE COMPL
CASING/CEMENT JOB
DOWNHOLE COMMINGLE
CLOSED-LOOP SYSTEM
OTHER:
OTHER:
13. Describe proposed or completed operations. (Clearly state all pertinent details, and give pertinent dates, including estimated date
of starting any proposed work). SEE RULE 19.15.7.14 NMAC. For Multiple Completions: Attach wellbore diagram of
proposed completion or recompletion.
Spud Date:
Rig Release Date:
I hereby certify that the information above is true and complete to the best of my knowledge and belief.
SIGNATURE__________________________________ TITLE___________________________________DATE___________________
Type or print name _____________________________ E-mail address: __________________________ PHONE: ________________
For State Use Only
APPROVED BY:_______________________________TITLE___________________________________DATE___________________
Conditions of Approval (if any):
Submit 1 Copy To Appropriate District
State of New Mexico
Form C-103
Office
Revised July 18, 2013
Energy, Minerals and Natural Resources
District I – (575) 393-6161
WELL API NO.
1625 N. French Dr., Hobbs, NM 88240
District II – (575) 748-1283
OIL CONSERVATION DIVISION
811 S. First St., Artesia, NM 88210
5. Indicate Type of Lease
District III – (505) 334-6178
1220 South St. Francis Dr.
STATE
FEE
1000 Rio Brazos Rd., Aztec, NM 87410
Santa Fe, NM 87505
District IV – (505) 476-3460
6. State Oil & Gas Lease No.
1220 S. St. Francis Dr., Santa Fe, NM
87505
SUNDRY NOTICES AND REPORTS ON WELLS
7. Lease Name or Unit Agreement Name
(DO NOT USE THIS FORM FOR PROPOSALS TO DRILL OR TO DEEPEN OR PLUG BACK TO A
DIFFERENT RESERVOIR. USE "APPLICATION FOR PERMIT" (FORM C-101) FOR SUCH
PROPOSALS.)
8. Well Number
1. Type of Well: Oil Well
Gas Well
Other
2. Name of Operator
9. OGRID Number
3. Address of Operator
10. Pool name or Wildcat
4. Well Location
Unit Letter___________:__________feet from the _____________ line and _____________feet from the ____________line
Section
Township
Range
NMPM
County
11. Elevation (Show whether DR, RKB, RT, GR, etc.)
12. Check Appropriate Box to Indicate Nature of Notice, Report or Other Data
NOTICE OF INTENTION TO:
SUBSEQUENT REPORT OF:
PERFORM REMEDIAL WORK
PLUG AND ABANDON
REMEDIAL WORK
ALTERING CASING
TEMPORARILY ABANDON
CHANGE PLANS
COMMENCE DRILLING OPNS.
P AND A
PULL OR ALTER CASING
MULTIPLE COMPL
CASING/CEMENT JOB
DOWNHOLE COMMINGLE
CLOSED-LOOP SYSTEM
OTHER:
OTHER:
13. Describe proposed or completed operations. (Clearly state all pertinent details, and give pertinent dates, including estimated date
of starting any proposed work). SEE RULE 19.15.7.14 NMAC. For Multiple Completions: Attach wellbore diagram of
proposed completion or recompletion.
Spud Date:
Rig Release Date:
I hereby certify that the information above is true and complete to the best of my knowledge and belief.
SIGNATURE__________________________________ TITLE___________________________________DATE___________________
Type or print name _____________________________ E-mail address: __________________________ PHONE: ________________
For State Use Only
APPROVED BY:_______________________________TITLE___________________________________DATE___________________
Conditions of Approval (if any):