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Begin by filling out Part 1: Operator Information. Enter your FEIN/SSN, Operator Number, and the name and mailing address of the operator. Ensure all fields are completed accurately.
In Part 2: Requested Changes, provide the Oklahoma Tax Commission production unit number and lease name. Specify the well names/numbers affected by this change.
Check the appropriate boxes for changes being made regarding product codes, incentive codes, or ownership changes. Fill in effective dates as required.
Complete Part 3 by declaring that the information provided is true and correct. Type or print your name, title, sign, and date the form.
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