Department of Administration

Alaska Oil and Gas Conservation Commission

Alaska Department of Administration, Alaska Oil and Gas Conservation Commission
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The AOGCC has revised the following forms, and made them available on this web site.  As other forms are revised, they will be posted here.  If you do not see the form you need, please contact the AOGCC directly at:

333 W. 7th Ave., Ste. 100
Anchorage, AK  99501
(907) 279-1433

Please be aware of the following updates:

  1. All forms are available in pdf and Excel format.
  2. The AOGCC periodically revises application and reporting forms. Obsolete forms are not accepted. Please read this notice.
  3. Instructions are available on the last page of selected forms.
  4. API numbers should be completed as a 14-digit number (Ex:  50-123-12345-00-00).
  5. Be aware that some information locations have changed.
  6. 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.
  7. 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.
  8. Cells in form 10-412 should be formatted as text or date only.
  9. Safety Valve System (SVS) test report form is updated regularly and sent directly to operator. Questions should be directed to


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Form Name and Number Format No. of Pages Revised
Permit to Drill (10-401) PDF Excel 1 10/2012
Surety Bond (10-402A) PDF 2 04/2011
Personal Bond (10-402B) PDF 2 05/2012
Assignment of CD Form PDF   5 06/2012
Application for Sundry Approvals (10-403) PDF Excel 1 05/2015
Annular Disposal Application (10-403AD) PDF Excel 2 06/2004
Report of Sundry Well Operations (10-404) PDF Excel 1 05/2015
Monthly Production Report (10-405) PDF Excel 2 04/2006
Monthly Injection Report (10-406) PDF Excel 2 02/2006
Well Completion or Recompletion Report and Log (10-407) PDF Excel 2 05/2015
Well Status Report and Gas-Oil Ratio Tests (10-409) PDF Excel 2 12/2003
Designation of Operator (10-411) PDF Excel 1 07/2009
Reservoir Pressure Report (10-412) *See #8 above PDF Excel 2 04/2009
Report of Injection Project (10-413) PDF Excel 1 12/2003
Notice of Ownership (10-417) PDF Excel 1 12/2005
Gas Well Open Flow Potential Tests Report (10-421) PDF Excel 2 07/2009
Facility Report of Produced Gas Disposition (10-422) PDF Excel 2 05/2009
    Facility Codes for 10-422  
    Import Form for 10-422 Excel 1 07/2009
    Import Form for Flaring Events > 1 Hour for 10-422 Excel 1 07/2009
Report of Annular Disposal (10-423) PDF Excel 2 02/2004
Blow-Out Preventer Equipment (BOPE) Test (10-424)   Excel 1 6/2014
Diverter Test (10-425)   Excel 1 08/2014
Mechanical Integrity Test (MIT) (10-426)   Excel 1 11/2012
Application for Certification of Gas Storage Capacity(10-427) PDF Excel 2 10/2012
Data Request Form PDF   1 06/2012
Test Witness Notification Web Form   11/2012