OHIO DEPARTMENT OF NATURAL RESOURCES
DIVISION OF OIL & GAS RESOURCES MANAGEMENT
2045 Morse Road, F-2 • Columbus, OH 43229-6693
(614) 265-6922 • Production@dnr.ohio.gov
Quarterly Statement of Production (Form 10-H) Instructions Rev. 3/2023
Required by Ohio Revised Code 1509.11 of any owner of a well that is not a horizontal well as defined in ORC 1509.01(GG).
The Form 10-H must be submitted on or before the 45
th
day after the calendar quarter for reporting the preceding quarter’s
production.
Quarterly Statement of Production (Form 10-H) Rev. 3/2023 Instructions, Page 1 of 2
ODNR DOGRM
General Information
• Production must be submitted for each well producing or capable of producing oil and/or gas.
o Owners with more than 100 wells are required to submit production information electronically, but all owners
may submit production information electronically to Production@dnr.ohio.gov.
o Electronic forms are available at https://ohiodnr.gov/oilandgasproduction or by contacting the Division at
(614) 265-6922 or Producti[email protected]hio.gov.
• Conventional well owners are required to submit a Form 10-H on or before the 45
th
day after the calendar
quarter for the preceding calendar quarter.
Specific Instructions Regarding Form 10-H
Section I – Owner Information (Required)
• All fields in this section are required, except for 24-Hour Emergency Phone Number and Email.
• The Owner Number is the unique number assigned to each owner by the Division.
Section II – Well Information (Required)
• All fields in this section are required to be completed.
• The API Number is 14 digits and must be entered accurately without dashes (ex: 34001210000000). Inaccurat
e
r
eporting of an API Number will result in a delay of the statement of production being processed.
Section III – Production Reporting (Required)
• All fields are required to be completed. Numerical entries are required. Enter a zero in any field where it is
applicable.
• Production information is to be submitted as follows: oil in the quantity of barrels, gas in the quantity of MCF
(thousand cubic feet of gas), and brine in the quantity of barrels. Enter the number of days that the well was i
n
production.
Ohio law does not require the separate reporting of Natural Gas Liquids (NGLs) or condensate.
NGLs must be reported as gas and condensate must be reported as oil.
• Production quantities are to be calculated at the nearest point from which the oil, gas, or brine is severed, or
removed, from the ground.
o Owners must report all gas severed, including gas used on-site and for domestic use.
o Production must be calculated at the time when minerals are severed, not at the time of shipping or from
s
ales.
o Line loss, flaring, gas shrinkage, and compression cannot be deducted from the amount of production.
• If multiple wells produce through a common meter or tank, the owner is responsible for reporting the producti
on
of each well accurately.
• If ownership of a well transfers or if well status change occurs, such as the plugging of a well, the owner is still
required to submit production information for the timeframe in which the well was owned or for the period of
time before the well was plugged.
Quarterly Statement of Production (Form 10-H) Instructions, continued
Quarterly Statement of Production (Form 10-H) Rev. 3/2023 Instructions, Page 2 of 2
ODNR DOGRM
Section IV – Real Property Tax Adjustment for Volume Sold (Optional)
• The Ohio Department of Taxation has requested that the Division collect this information. Ohio law calls for t
he
us
e of the volume of product sold and the date of first production to calculate real property taxes for the
following tax year. For questions regarding Section IV, please contact the Ohio Department of Taxation, Tax
Equalization Division at (614) 466-5744.
• If this section is not completed, the real property taxes will be calculated using the volume of product produced
as
reported on this form.
• If the well was first brought into production during the reporting period, you may claim a flush production credit
by entering the actual date the well first produced, in the “Actual Date of First Production” box. Call the Tax
Equalization Division at (614) 466-5744 for questions about “flush production credit.”
• These fields are not required to satisfy ORC 1509.11(A)(2).
Section V – Domestic User Information (Optional)
• The Division has included this section so that landowners can be notified timely in the case of an emergency
situation.
• These fields are not required to satisfy ORC 1509.11(A)(2).
Section VI – Well Status Changes During the Reporting Period (If Applicable)
• Select one status that best represents the well status change during the reporting period and add additional
notes as required if the well was transferred, plugged, or placed in an approved temporary inactive status:
o Plugged: Provide the date the well was plugged. A completed Well Plugging Report (Form 55) must b
e
submitted to the Division. Electronic forms are available at https://ohiodnr.gov/oilandgasdocuments if this
step has not already been taken. See ORC 1509.14 for additional information.
o Transferred: Provide the date of transfer and identify the other party associated in the transaction. A
completed Change of Owner Form (Form 7) must be submitted to the Division. Electronic forms ar
e
av
ailable at https://ohiodnr.gov/oilandgasdocuments. See ORC 1509.31 for additional information.
o Temporary Inactive Status: Provide the date this status was approved by the Division. See ORC 1509.062
for additional information.
Section VII – Tank Information (Optional)
• We are adding this information to build an electronic State Emergency Response Commission (SERC)
reporting system that you may utilize to file annual reports.
• Please report on the entire tank battery for this well.
o Identifying information for the tank battery, which is a unique name and/or number assigned by the owner or
others.
o List the latitude and longitude, number of tanks, and total storage capacity of the tank battery.
- If you are unable to provide an accurate latitude and longitude for a tank battery, please contact t
he
D
ivision for assistance at (614) 265-6922 or Production@dnr.ohio.gov.
o List the API Number(s) of all wells that produce oil, brine, or condensate into the tank battery.
- The API Number is 14 digits and must be entered accurately without dashes (ex: 34001210000000).
Inaccurate reporting of an API Number will result in a delay of the statement of production bei
ng
pr
ocessed.
• These fields are not required to satisfy ORC 1509.11(A)(2) but will be required under the reporting
requirements of ORC 1509.231.
Section VIII – Signature (Required)
• Form 10-H must be signed by the owner of the well as defined in ORC 1509.01(K) or the authorized agent of
the owner.
P
lease call the Division at (614) 265-6922 or email Production@dnr.ohio.gov if you have questions.
OHIO DEPARTMENT OF NATURAL RESOURCES
DIVISION OF OIL & GAS RESOURCES MANAGEMENT
2045 Morse Road, F-2 • Columbus, OH 43229-6693
(614) 265-6922 • Production@dnr.ohio.gov
Quarterly Statement of Production (Form 10-H) Rev. 3/2023
Required by Ohio Revised Code 1509.11 of any owner of a well that is not a horizontal well as defined in ORC 1509.01(GG).
The Form 10-H must be submitted on or before the 45
th
day after the calendar quarter for reporting the preceding quarter’s production.
Quarterly Statement of Production (Form 10-H) Rev. 3/2023 Form 10-H, Page 1 of 2
ODNR DOGRM
For Calendar Quarter Ending ________________
Modification to a previously submitted report.
Reason:
Section I. Owner Information Required
Owner Name:
Owner Number:
Mailing Address:
Optional
City / State / Zip: Email:
Office Phone: 24-Hour Emergency Phone:
Section II. Well Information Required
API Number:
Well Name:
Well Number:
County:
Township:
Section III. Production Information Required
Oil Produced (BBL)
Gas Produced (MCF)
Brine Produced (BBL)
Section IV. Real Property Tax Information Optional
Oil Sold (BBL)
Gas Sold (MCF)
Actual Date of
First Production
Section
V. Domestic User Information Optional
No Domestic User
Domestic User Name
Domestic User Address
City State Zip
Phone
Section VI. Well Status Changes During Reporting Period If applicable.
Select one.
Plugged on
MM/DD/YYYY
Transferred on
MM/DD/YYYY
To:
Temporary Inactive Status Approved on
MM/DD/YYYY
Quarterly Statement of Production (Form 10-H), continued
Quarterly Statement of Production (Form 10-H) Rev. 3/2023 Form 10-H, Page 2 of 2
ODNR DOGRM
For Calendar Quarter Ending ________________
Section VII. Tank Information Optional
No Storage Tank Common Tank Battery
Name: Number of Tanks:
Total Storage: (BBL)
County:
Township:
Municipality:
Section:
Lot:
Latitude:
Longitude:
Tank 1 Storage (BBL)
Tank 1 Contents
All API numbers associated with tank
Tank 2 Storage (BBL)
Tank 2 Contents
All API numbers associated with tank
Tank 3 Storage (BBL)
Tank 3 Contents
All API numbers associated with tank
Tank 4 Storage (BBL)
Tank 4 Contents
All API numbers associated with tank
Tank 5 Storage (BBL)
Tank 5 Contents
All API numbers associated with tank
Please add copies of this page for additional tanks.
Section VIII. Signature Required
The signature must be that of the owner of the well as defined in ORC 1509.01 (K) or the authorized agent of the owner.
Print Name: Title:
My signature below certifies that the information provided is true and accurate to the best of my knowledge,
under penalty of law.
Signature:
Date: