Form EIA-64A Annual Report of the Origin of Natural Gas Liquids Produ

This form may be submitted to the EIA by mail, fax, e-mail, or secure file transfer. Should you choose to submit your data via e-mail, we must advise you that e-mail is an insecure means of transmission because the data are not encrypted, and there is some possibility that your data could be compromised. You can also send your Excel files to EIA using a secure method of transmission: HTTPS. This is an industry standard method to send information over the web using secure, encrypted processes. (It is the same method that commercial companies communicate with customers when transacting business on the web.) To use this service, we recommend the use of Microsoft Internet Explorer 5.5 or later or Netscape 4.77 or later. Send your surveys using this secure method at: https://idc.eia.doe.gov/upload/noticeoog.jsp.

OMB No. 1905-0057

Expiration Date: xx/xx/xxxx

Version No: xxxx.xx

Burden: 6 hours

ANNUAL REPORT OF THE ORIGIN OF NATURAL GAS LIQUIDS PRODUCTION

FORM EIA-64A

REPORT YEAR 201X

This report is mandatory under Public Law 93-275. Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by law. For the sanctions and the provisions concerning the confidentality of information submitted on this form, see sections F and G on page 2 in the instructions. 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.

RESPONDENT INFORMATION

1.0 Does this report reflect active natural gas processing at the facility for the entire year?

Yes

No

Months covered by this report:

through

201X

Explain in 7.0 Comments below.

2.0 Submission Status:

Original

Amended

EIA ID NUMBER:

Submit completed form by April 19, 201X via:

3.1 Plant Name:

Secure File Transfer:

3.2 Geographic Location:

Use Area of Origin Codes on page 6

https://signon.eia.doe.gov/upload/noticeoog.jsp

3.3 Operating Co. Name:

3.4 Room / Suite Number:

Email: OOG.SURVEYS@eia.doe.gov

Street / PO Box:

City:

Fax: 202-586-1076

State:

Zip Code:

-

Mail: Oil & Gas Surveys

U. S. Department of Energy, EIA

3.5 Operating Co. Contact Name:

Ben Franklin Station

PO Box 279

Phone No.:

-

-

Ext:

Washington DC 20044-0279

Fax No.:

-

-

Questions? Call the EIA-64A Coordinator

1-800-879-1470

Email Address:

between 9:00 a.m. and 4:30 p.m. Eastern Time

ORIGIN OF NATURAL GAS RECEIVED AND NATURAL GAS LIQUIDS PRODUCED

Line

Area of Origin Code

Natural Gas Received

Natural Gas Liquids Production

Millions of Cubic Feet (MMCF)

Thousands of Barrels (MBls)

(A)

(B)

(C)

4.1

4.2

4.3

4.4

4.5

4.6

4.7

4.8

TOTAL

0

0

5.0

Gas Shrinkage Resulting from Natural Gas Liquids Extracted (MMCF)

6.0

Natural Gas Used as Fuel in Processing (MMCF)

7.0

Comments: Identify any unusual aspects of your operations during the report month. (To start a new line, use alt + enter.)