Alaska Department of Administration

Alaska Oil and Gas Conservation Commission


  1. The AOGCC periodically revises application and reporting forms. Obsolete forms are not accepted.
  2. API numbers should be completed as a 14-digit number (Ex:  50-123-12345-00-00).
  3. Certain forms may no longer be required in multiple submittals.  Please look in the lower right hand corner to determine the current number of submittals required.
  4. 10-404, 10-407 - Submit a well schematic diagram with each 10-407 well completion report and 10-404 well sundry report when the downhole well design is changed.
  5. 10-412 - Cells should be formatted as text or date only.
  6. Safety Valve System (SVS) test report form. Questions should be directed to Phoebe Brooks
  7. 10-405, 10-406 - EDI file instructions for Production & Injection Data Submittal


Form Name and Number
Permit to Drill (10-401) PDF   Excel 05/2017
Surety Bond (10-402A) PDF 04/2011
Personal Bond (10-402B) PDF 05/2012
Assignment of CD Form PDF 06/2012
Application for Sundry Approvals (10-403) PDF   Excel 04/2017
Annular Disposal Application (10-403AD) PDF   Excel 06/2004
Report of Sundry Well Operations (10-404) PDF   Excel 04/2017
Monthly Production Report (10-405) PDF   Excel 04/2006
Monthly Injection Report (10-406) PDF   Excel 02/2006
Well Completion or Recompletion Report and Log (10-407) PDF   Excel 05/2017
Well Status Report and Gas-Oil Ratio Tests (10-409) PDF   Excel 12/2003
Designation of Operator (10-411) PDF   Excel 07/2009
Reservoir Pressure Report (10-412) PDF   Excel 04/2009
Report of Injection Project (10-413) PDF   Excel 12/2003
Notice of Ownership (10-417) PDF   Excel 12/2005
Gas Well Open Flow Potential Tests Report (10-421) PDF   Excel 07/2009
Facility Report of Produced Gas Disposition (10-422)
Facility Codes for 10-422
Import Form for 10-422
Import Form for Flaring Events > 1 Hour for 10-422
PDF   Excel 05/2009
Report of Annular Disposal (10-423) PDF   Excel 02/2004
Blow-Out Preventer Equipment (BOPE) Test (10-424) Excel 04/2018
Diverter Test (10-425) Excel 04/2018
Mechanical Integrity Test (MIT) (10-426) Excel 01/2017
Application for Certification of Gas Storage Capacity(10-427) PDF   Excel 10/2012
Annual Reservoir Properties Report (10-428) Excel 05/2017
Data Request Form PDF 06/2012
Test Witness Notification Web Form 11/2012