EIA-23L Annual Survey of Domestic Oil and Gas Reserves (Field Ve

U.S. DEPARTMENT OF ENERGY ENERGY INFORMATION ADMINISTRATION Washington DC 20585

Form Approved XXXXXX XXXX OMB No. 1905-0057 Expiration Date: xx/xx/xxxx Burden: 47.1 hours Version No. xxxx.xx

FORM EIA-23L ANNUAL SURVEY OF DOMESTIC OIL AND GAS RESERVES

SURVEY YEAR 2 0 1 2 COVER PAGE

This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). For the provisions concerning the confidentiality of information and sanction statements, see Section VII and VIII of the instructions.

Resubmission?

PART I. IDENTIFICATION

Complete and return by XXXXX xx, 2013 to: Oil and Gas Surveys U.S. Department of Energy, EIA Ben Franklin Station P O Box 279 Washington DC 20044-0279 OR Fax to 202 586-1076 / Form EIA-23L Questions? Call 1-800-879-1470

EIA Operator ID Code Operator Name Street or PO Box City, State, Zip Code

Enter EIA Operator ID number, if not shown.

0

0

0

0

1. Contact Information (person most knowledgeable about the reported data) Contact Person ______________________________________________ Phone Number _______________________________Ext ____________ Fax Number ______________________________________________ E-mail Address ______________________________________________

2. Was your company an oil and gas field operator at any time during survey year 2012? (See B. Who Must Submit, page 2) (1) ¨ No Complete only items 3 -8 below and return this page (2) ¨ Yes Complete all of the form

3. Company Status, Name, and/or Address Change or Correction (Check appropriate box.)

¨ Name and address on mailing label are correct.

¨ Change company name, contact person, and/or mailing address as indicated below.

¨ Company was sold to or merged with company entered below.

¨ Company went out of business. Operations transferred to company entered below .

4. Enter Changes to Company Name, Address, and/or Contact Information

Company Name

Street or PO Box

City, State, Zip Code

Contact Person (Please Print)

Phone Number Ext

Fax:

Email Address

Comments

PART II. APPROVAL

5. Reviewed and approved by (Please Print)

6. Title

7. Signature

8. Date

Title 18 USC 1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction.

OFFICIAL USE ONLY

2012

FORM EIA-23L ANNUAL SURVEY OF DOMESTIC OIL AND GAS RESERVES SCHEDULE A - OPERATED PROVED RESERVES, PRODUCTION, AND RELATED DATA BY FIELD Report All Liquid Volumes in Thousands of Barrels [MBbls] at 60°F; Report All Volumes of Natural Gas in Millions of Cubic Feet [MMCF] at 60°F and 14.73 psia

Form Approved xxxxxx xxx OMB No. 1905-0057 Expiration Date: xx/xx/xxxx Burden: 47.1 hours Version No.: xxxx.xx

1.0 OPERATOR DETAILED DATA REPORT

1.1 EIA OPERATOR ID CODE

1.2 OPERATOR NAME

SURVEY dATE

1.3 original

1.4 amended

1.5 page

12

31

12

______ of _____

2.0 field data (operated basis)

1. state Code

2. Subdiv Code

3. County Code

4. Field code

5. TYPE cODE

6. field name

7. PROVED NONPRODUCING RESERVES – DECEMBER 31, 2012

8. FOOTNOTE

2.1

CRUDE OIL (a) (MBbls)

ASSOCIATED-DISSOLVED (b) GAS (MMCF)

nonassociated (c) GAS (MMCF)

LEASE CONDENSATE (d) (MBbls)

9. water depth

10. field discovery year

11. prospect name (optional)

type of hydrocarbon

TOTAL PROVED reserves december 31, 2011 (A)

revision increases (B)

revision DEcreases (C)

SALES (D)

ACQUISITIONS (E)

EXTENSIONS (F)

new field discoveries (G)

new reservoirs in old fields (H)

SURVEY YEAR production (I)

TOTAL PROVED reserves december 31, 2012 (J)

12. CRUDE OIL (MBbls)

13. ASSOCIATED-DISSOLVED GAS (MMCF)

14. NONASSOCIATED GAS (MMCF)

15. LEASE CONDENSATE (MBbls)

1. state Code

2. Subdiv Code

3. County Code

4. Field code

5. TYPE cODE

6. field name

7. PROVED NONPRODUCING RESERVES – DECEMBER 31, 2012

8. FOOTNOTE

2.2

CRUDE OIL (a) (MBbls)

ASSOCIATED-DISSOLVED (b) GAS (MMCF)

nonassociated (c) GAS (MMCF)

LEASE CONDENSATE (d) (MBbls)

9. water depth

10. field discovery year

11. prospect name (optional)

type of hydrocarbon

TOTAL PROVED reserves december 31, 2011 (A)

revision increases (B)

revision DEcreases (C)

SALES (D)

ACQUISITIONS (E)

EXTENSIONS (F)

new field discoveries (G)

new reservoirs in old fields (H)

SURVEY YEAR production (I)

TOTAL PROVED reserves december 31, 2012 (J)

12. CRUDE OIL (MBbls)

13. ASSOCIATED-DISSOLVED GAS (MMCF)

14. NONASSOCIATED GAS (MMCF)

15. LEASE CONDENSATE (MBbls)

1. state Code

2. Subdiv Code

3. County Code

4. Field code

5. TYPE cODE

6. field name

7. PROVED NONPRODUCING RESERVES – DECEMBER 31, 2012

8. FOOTNOTE

2.3

CRUDE OIL (a) (MBbls)

ASSOCIATED-DISSOLVED (b) GAS (MMCF)

nonassociated (c) GAS (MMCF)

LEASE CONDENSATE (d) (MBbls)

9. water depth

10. field discovery year

11. Prospect name (optional)

type of hydrocarbon

TOTAL PROVED reserves december 31, 2011 (A)

revision INcreases (B)

revision DEcreases (C)

SALES (D)

ACQUISITIONS (E)

EXTENSIONS (F)

new field discoveries (G)

new reservoirs IN old fields (H)

SURVEY YEAR production (I)

TOTAL PROVED reserves december 31, 2012 (J)

12. CRUDE OIL (MBbls)

13. ASSOCIATED-DISSOLVED GAS (MMCF)

14. NONASSOCIATED GAS (MMCF)

15. LEASE CONDENSATE (MBbls)

OFFICIAL USE ONLY		2012	FORM EIA-23L ANNUAL SURVEY OF DOMESTIC OIL AND GAS RESERVES SCHEDULE B – FOOTNOTES			Form Approval XXXXXX XXXX OMB No. 1905-0057 Expiration Date: XX/XX/XXXX Burden: 47.1 hours Version No: XXXX.XX

1.1 EIA OPERATOR ID CODE

1.2 OPERATOR NAME

SURVEY DATE

1.3 ORIGINAL

1.4 AMENDED

1.5 PAGE

12

31

12

____ of ____

STATE CODE (A)

SUBDIV CODE (B)

COUNTY CODE (C)

FIELD CODE (D)

TYPE CODE (E)

HYDRO- CARBON TYPE (F)

COLUMN (G)

FOOTNOTES (H)