KANSAS CORPORATION COMMISSION
OIL & GAS CONSERVATION DIVISION
LICENSE DEPARTMENT
REQUEST
TO ADD DRILLING OR WELL SERVICING EQUIPMENT
TO OPERATOR LICENSE
To obtain authority to operate drilling or well servicing equipment under the provisions
of the laws of Kansas, KSA 55-155, please complete the following and provide the
required fees and documentation.
DATE_______________
Company/Individual _______________________________ Phone (__)_________
Address__________________________________________
City/State/Zip_____________________________________
KCC License #_________
Expiration date of License_________
Please complete the following information for all equipment being licensed. *
YEAR
MAKE
MODEL
TYPE OF EQUIPMENT
*Kansas taxed Licensee: Attach a copy of equipment assessment rendition sheets
and paid personal property tax receipts or a Bill of Sale.
Remittance enclosed: $25.00 per equipment tag = $_____________
Mail to: KCC – Conservation Division, Licensing Department, 266 N Main St,
Ste 220, Wichita, KS 67202-1513
Phone: (316) 337-6194
KANSAS CORPORATION COMMISSION
OIL & GAS CONSERVATION DIVISION
LICENSE DEPARTMENT
REQUEST
TO ADD DRILLING OR WELL SERVICING EQUIPMENT
TO OPERATOR LICENSE
To obtain authority to operate drilling or well servicing equipment under the provisions
of the laws of Kansas, KSA 55-155, please complete the following and provide the
required fees and documentation.
DATE_______________
Company/Individual _______________________________ Phone (__)_________
Address__________________________________________
City/State/Zip_____________________________________
KCC License #_________
Expiration date of License_________
Please complete the following information for all equipment being licensed. *
YEAR
MAKE
MODEL
TYPE OF EQUIPMENT
*Kansas taxed Licensee: Attach a copy of equipment assessment rendition sheets
and paid personal property tax receipts or a Bill of Sale.
Remittance enclosed: $25.00 per equipment tag = $_____________
Mail to: KCC – Conservation Division, Licensing Department, 266 N Main St,
Ste 220, Wichita, KS 67202-1513
Phone: (316) 337-6194
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