Texas Form W 14 PDF Details

Are you a Texas resident and preparing to file your state taxes? Look no further than the Texas Form W-14! This essential form is important for many taxpayers across the Lone Star State, as it's required to be submitted alongside both state and federal income tax returns. With this blog post, we'll discuss everything you need to know about completing the form correctly - including what it is, who should file it, how to submit it properly and why filing your return with Form W-14 is so important. Keep reading to get started on ensuring that all of your 2021 tax filings are taken care of correctly!

QuestionAnswer
Form NameTexas Form W 14
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesUIC, tx, RRC, TEXAS

Form Preview Example

RAILROAD COMMISSION OF TEXAS

OIL AND GAS DIVISION

Form W-14

05/2004

APPLICATION TO DISPOSE OF OIL AND GAS WASTE BY INJECTION

INTO A FORMATION NOT PRODUCTIVE OF OIL AND GAS

1 .Operator Name ______________________________________________________________ 2. Operator P-5 No. ________________________

3. Operator Address: _______________________________________________________________________________________________________

4. County ____________________________________________________________________

5. RRC District No. ________________________

6. Field Name _________________________________________________________________

7. Field Number ____________________________

8. Lease Name ________________________________________________________________

9. Lease/Gas ID No. _________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

Well is ______ miles in a ________ direction from __________________________ (center of nearest town).

11. No. acres in lease _______

12.

Legal description of location including distance and direction from survey lines___________________________________________________

13.

Latitude/Longitude, if known (Optional)

 

 

Lat. ____________________________ Long. __________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

New Permit:

 

Yes

 

No

 

 

 

 

If no, amendment of Permit No. __________________ UIC# _________________________

15.

Reason for amendment:

 

 

Pressure

 

 

Volume

Interval

Commercial

Other (explain) _____________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16.Well No.

 

17.API

No.

 

 

 

 

18.Date Drilled

 

 

 

 

19.Total Depth

 

 

 

20.Plug Date, if re-entry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Casing

 

Size

 

 

 

Setting

 

 

Hole Size

Casing

 

Cement

 

Cement

 

Top of

 

Top Determined by

 

 

 

 

 

 

 

Depths

 

 

 

Weight

 

Class

 

Sacks (#)

 

cement

 

 

 

 

 

21.

Surface

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22.

Intermediate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23.

Long String

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24 .Liner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25.

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26.

Depth to base of Deepest Freshwater Zone ___________________

27.Multiple completion?

 

 

Yes

No

 

28.

Multistage cement?

Yes

 

No

 

 

If yes, DV Tool Depth: ________ft.

No. Sacks: ________Top of Cement: _________

29.

Bridge Plug Depth: ________ ft.

30. Injection Tubing

Size: _____ in. and Depth ______ ft.

31. Packer Depth: ________ft.

32.

Cement Squeeze Operations (List all giving interval and number of sacks of cement and cement top and whether Proposed or Complete.):

 

 

 

 

 

 

33.

Injection Interval from __________ to _________ ft.

 

34. Name of Disposal Formation _______________________________

35.

Any Oil and Gas Productive Zone within two miles? Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, Depth _______________ ft. and Reservoir Name ______________________________________________________________________

 

 

 

 

 

 

36.

Maximum Daily Injection Volume __________ bpd

 

37. Estimated Average Daily Injection Volume _______________bpd

38.

Maximum Surface Injection Pressure ________ psig

 

39. Estimated Average Surface Injection Pressure____________ psig

 

 

 

 

 

40.

Source of Fluids (Formation, depths and types): ____________________________________________________________________________

41.

Are fluids from leases other than lease identified in Item 8? Yes

 

No

42. Commercial Disposal Well?

Yes

No

43.

If commercial disposal, will non-hazardous oil and gas waste other than produced water be disposed of?

 

 

 

Yes

No

44.

Type(s) of Injection Fluid:

 

Salt Water

Brackish Water

 

Fresh Water

 

 

CO2

N2

Air

H2S

 

LPG

 

NORM

 

 

Natural Gas

Polymer

 

Other (explain) _______________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFICATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare under penalties prescribed in Sec. 91.143, Texas Natural

____________________________________________________________

Resources Code, that I am authorized to make this report, that this

Signature

 

 

 

 

 

 

 

 

 

 

Date

report was prepared by me or under my supervision and direction, and

____________________________________________________________

that the data and facts stated therein are true, correct, and complete, to

Name of Person (type or print)

 

 

 

 

 

 

 

the best of my knowledge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone __________________________ Fax ________________________

FOR OFFICE USE ONLY

 

 

 

 

REGISTER NO.

 

 

 

 

 

 

 

 

AMOUNT $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT ALSO MUST COMPLY WITH THE INSTRUCTIONS ON THE REVERSE SIDE

05/2004

FORM W-14 INSTRUCTIONS

1.File the original application, including all attachments, with Environmental Services, Railroad Commission of Texas, P.O. Box 12967, Austin, Texas 78711-2967. File one copy of the application and all attachments with the appropriate district office.

2.Include with the original application a non-refundable fee of $100 payable to the Railroad Commission of Texas. Submit an additional $150 fee for each request for an exception to Statewide Rule 9(9) relating to Special Equipment.

3.Provide the current field name (Item 6) and field number (Item 7) designated in Commission records for an existing well. If the application is for a new well, provide the nearest producing field name and number.

4.Check in Item 14 the appropriate box for a new permit or an amendment of an existing permit. If an amendment, check the applicable boxes in Item 15 to indicate the reason for amendment and provide a brief explanation if “other” is checked.

5.If the application is for a new permit, attach a complete electrical log of the well or the log of a nearby well.

6.Attach a letter from the Texas Commission on Environmental Quality (TCEQ) or its predecessor or successor agency stating that the well will not endanger usable quality water strata and that the formation or stratum to be used for disposal does not contain usable quality water. To obtain the TCEQ letter, submit two copies of the Form W-14, a plat with surveys marked, and a representative electrical log to TCEQ, MC 151, P.O. Box 13087, Austin, Texas 78711-3087. NOTE: If the application is for an amendment, a new TCEQ letter is required only if the amendment is for a change in the disposal interval.

7.Attach a map showing the location of all wells of public record within one-half (1/2) mile radius of the proposed disposal well. On the map show each Commission-designated operator of each well within one-half (1/2) mile of the proposed disposal well. NOTE: For a commercial disposal well application, the map shall also show the ownership of the proposed disposal well tract and the surface tracts that adjoin the proposed disposal well tract.

8.Attach a table of all wells of public record that penetrate the disposal interval and that are within one-quarter (1/4) mile radius of the proposed disposal well. The table shall include the well identification, date drilled, depth, current status, and the plugging dates of those wells that are plugged. Identify any wells that appear to be or that you may know are unplugged or improperly plugged and penetrate the proposed injection interval. Alternatively, an applicant may request a variance under Rule 9(7)(B). NOTE: If the application is for an amendment, a table of wells within a one-quarter (1/4) mile radius is required only if the current permit was issued before April 1, 1982, or if the amendment is for a shallower disposal depth.

9.Attach a list of the names and mailing or physical addresses of affected persons who were notified of the application and when the notification was mailed or delivered. Include a signed statement attesting to the notification of the listed affected persons. Notice shall be provided by sending or delivering a copy of the front and back of the application to the surface owner of record of the surface tract where the well is located, each Commission- designated operator of any well located within one-half (1/2) mile of the proposed well, the county clerk, and the city clerk, or other city official, if the proposed well is located within municipal boundaries. In addition, notice of a commercial disposal well also shall be provided to surface owners of record of each surface tract that adjoins the surface tract where the proposed well will be located. NOTE: If the application is for an amendment, notification of the county clerk and the city clerk are required only if the amendment is for disposal interval or for commercial status.

10.Attach an affidavit of publication signed by the publisher that the notice of publication has been published in a newspaper of general circulation in the county where the disposal well will be located. Attach a newspaper clipping of the published notice. If the application is for a commercial disposal well, that fact must be stated in the published notice. NOTE: If the application is for an amendment, notification by publication is required only if the amendment is for disposal interval or for commercial status.

11.Attach any other technical information that you believe will facilitate the review of the application. Such information may include a cement bond log, a cementing record, or a well bore sketch.

Additional information is available in the Underground Injection Control Manual, which is available on the Railroad Commission’s website: www.rrc.state.tx.us

No public hearing will be held on this application unless an affected person or local government protests the application, or the Commission administratively denies the application. Any protest shall be in writing and contain (1) the name, mailing address, and phone number of the person making the protest; and (2) a brief description of how the protestant would be adversely affected by the activity sought to be permitted. If the Commission or its delegate determines that a valid protest has been received, or that a public hearing is in the public interest, a hearing will be held upon written request by the applicant. The permit may be administratively issued in a minimum of 15 days after receipt of the application, published notice, or notification of affected persons, whichever is later, if no protest is received.