Forms

On this page you will find forms related to petroleum and geothermal applications and title administration. Forms not listed on this page are now available for download through the Petroleum and Geothermal Register (PGR). These forms are to be submitted via PGR using the online lodgement facility as this is the departments approved and only method for receiving these application types.

Note: Some documents are currently not accessibility compliant. Please contact the Online Services on Ph: +61 8 9222 3333 or email: online@dmirs.wa.gov.au for a web accessible WCAG 2.0 version.

Access PGR to download and submit forms and lodge applications online.

Petroleum and Geothermal Register (PGR)

Annual Reporting Templates

Production Licence Annual Assessment template - 106 Kb

Production Licence Annual Assessment template

Exploration Permit Annual Assessment template - 79 Kb

Exploration Permit Annual Assessment template

Retention Lease Annual Assessment template - 85 Kb

Retention Lease Annual Assessment template

Production Licence Annual Assessment Report Guidance Notes - 261 Kb

Production Licence Annual Assessment Guidance Notes

Exploration Permit Annual Assessment Report Guidance Notes - 260 Kb

Exploration Permit Annual Assessment Report Guidance Notes

Retention Lease Annual Assessment Report Guidance Notes - 266 Kb

Retention Lease Annual Assessment Report Guidance Notes

Title Administration Forms

Request for Search of Petroleum Title

Dealing and transfer

Dealing Summary PGERA67 - 187 Kb

Dealing Summary

Dealing Summary PPA69 - 1500 Kb

Dealing Summary

Dealing Summary PSLA82 - 1503 Kb

Dealing Summary

Instrument of Transfer PGERA 67 - 1537 Kb

Form of Instrument of a Transfer of a Title under section 72

Instrument of Transfer PGERA 67 - 779 Kb

Form of Instrument of a Transfer of a Title under section 72 (word version)

Instrument of Transfer PPA 69 - 1156 Kb

Form of Instrument of a Transfer of a Licence under section 44

Instrument of Transfer PPA 69 - 779 Kb

Form of Instrument of a Transfer of a Licence under section 44 (word version)

Instrument of Transfer PSLA 82 - 1158 Kb

Form of Instrument of a Transfer of a Title under section 78

Instrument of Transfer PSLA 82 - 778 Kb

Form of Instrument of a Transfer of a Title under section 78 (word version)

Native Title Deeds

Please contact the Manager Resource Access on + 61 8 9222 3357 if you require a copy of a State Deed template, that is not listed below.

Noongar Standard Heritage Agreement - Proponent Statutory Declaration - 32 Kb

Noongar Standard Heritage Agreement - Proponent Statutory Declaration (Word Version)

Esperance Nyungar ILUA Proponent Standard Heritage Agreement - 179 Kb

Esperance Nyungar ILUA Proponent Standard Heritage Agreement

State Deed - Determined Native Title Holders - 66 Kb

State Deed - Determined Native Title Holders

State Deed - Native Title Claimants - 60 Kb

State Deed - Native Title Claimants

Noongar Standard Heritage Agreement - Proponent Statutory Declaration - 94 Kb

Noongar Standard Heritage Agreement - Proponent Statutory Declaration