Official Nebraska Government Website

NOGCC Forms


Forms are in Adobe Acrobat v8.1 (.pdf) format. The forms can be downloaded and completed on your computer, printed, signed, and submitted to us at: Nebraska Oil and Gas Conservation Commission, 922 Illinois, P.O. Box 399, Sidney, NE 69162. Please follow these instructions:
    1) To enable you to open, complete and print the forms on your computer, download and install Adobe Reader 8.1 if not previously installed, by clicking the link below.
    2) Right click the form and choose "Save Target As" if you wish to save the form to your computer.
    3) Open the form either by clicking the link here or by double clicking the saved version on your computer. Fill out all of the highlighted fields, print, sign and submit to us.
    4) If you wish to save completed forms on your computer, you must purchase Acrobat Approval, Acrobat Standard or Acrobat Professional.

Get Adobe Acrobat Reader

Forms:


Bonding
   Form 3A - Oil and Gas Operators Bond

Drilling Permit
   Form 2 - Notice of Intention to Drill or Re-enter
   Form 2A - Permit Application for a Temporary Earthen Reserve Pit
   Example Affidavit to Permit Unorthodox Well
   Affidavit to Permit Unorthodox Well

Injection/Disposal
   Form 11 SWD - Report of Disposal Well Activity
   Form 11 EOR - Report of Injection Project

Lease Reports
   Form 14 - Authorization to Transport Oil and/or Gas From Lease
   Form 15 - Retaining Pit Permit
   Form 15 - Instructions

Production
   Form 7A - Well Status and Monthly Production Report
   Form 7A - Instructions

Well Reports
   Form 4 - Sundry Notice
   Form 5 - Well Completion or Re-Completion Report
   Form 6 - Plugging Record
   Form 13 - Release from Further Plugging Liability

Incidents
   Report of Spill or Discharge of Oil or Salt Water