Alaska Logo
Department of Commerce, Community, and Economic Development
Alaska Oil and Gas Conservation
Commission
Loading...
HomeMy WebLinkAboutWolf Lake ProductionState of Alaska AOGCC Production Files Year: 2013 Field & Pool: WOLF LAKE Operator: HILCORP February 18, 2013 Marathon Alaska Production LLC Alaska Oil & Gas Conservation Commission Attn: Steve McMains 333 W 7" Avenue, Suite 100 Anchorage, AK 99501 Enclosed are the monthly production reports (Form 10-405), monthly injection report (10-406) and facility report of produced gas disposition (form 10-422) and the flare report for January, 2013 for the following fields: Beaver Creek Trading Bay Unit and Non Unit Kasilof Kenai Sterling Cannery Loop West Fork Ninilchik Wolf Lake I hereby certify that the reports submitted are true and correct to the best of my knowledge. If you have any questions regarding these reports, please call Matt Camp at 918-925-8106. Sincerely, ` - aT nA Matt Camp / IBM Business Analyst STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25 230 Name of 0,,r ,,: Marathon Oil Company Field and Pool: WOLF LAKE, TYONEK BEL LINDF Doth a: ad Yeartan-I3 I. Well No. 2. APT No. 3. Type 4. Field 5. Method 6. Days in Oper. ]. Tubing PSTG DAILY AVG, PRODUCTION TOTAL MONTFR,Y PRODUCTION 50-XXX-XXXXX-XX-X (see instruar) Pool Cade (see instruct) B. OIL (BBL) 9. WATER (BEL) 10. GAS (MCF) I I. OIL (BBL) 12. WATER (BBL) 13. GAS (MCF) WL -I RD W I. 2 1332036201 1332037590 2 2 951500 951500 8 8 0 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 hereby certify that the foregoing is nue and mover to the best of my knowledge. 14. Printed Name'. Matt Camp Title: Accountant Signature: 9Vatt am Date: February 21, 2013 TOTAL B 0 6 Form 10405 STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake FEBRUARY 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 1 hereby certify that the foregoing is true and correct to the best of my knowledge. Signed jae"C- j Q � 0 0 0 Jacob Owolabi TOTAL OIL WATER GAS Title Production Analyst Date: 3/18/2013 STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Poot: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC FEBRUARY 2013 1. Well No. 2. API No. 3. Type 50-XXX-XXXXX-XX-XX (see instruct.) 4. Fieltl 5. Methotl & Pool (see Code instruct.) 6. Days in Oper. 7. Avg. FTP psig (see instruct.) DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER (BBL) (BBL) 10. GAS (MCF) 11. OIL (BBL) 12. WATER (BBL) 1 13. GAS (MCF) WL 01 RD 50-133-20362-01-00 2951500 8 0 0 0 0 0 0 0 0 WL 02S 50-133-20375-90-00 2 951500 8 01 0 0 10 0 0 0 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Jaccobb�O/wwolabi Title: Production Analyst Signature: """ ' �" " """ ` Date: 3/18/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake MARCH 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory Opening Inventory Other Adjustments (direct or xylene recovered) Total Net Production I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed %a:L� OMMWA (r Jacob Owolabi Title Production Analyst Date: 4116/2013 0 0 WATER GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC MARCH 2013 1. Well No. 2. API No. 3. Type 4. Field 5. Method 6. Days in Oper. 7. Avg. FTP DAILY AVG. PRODUCTION I TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER 10. GAS 11. OIL 12. WATER 13. GAS 50-XXX-XXXXX-XX-XX (see & Pool (see psig (see instruct.) Code instruct.) instruct.) (BBL) (BBL) (MCF) i (BBL) (BBL) (MCF) I WL 01 RD 50-133-20362-01-00 2 951500 8 0 00 00 0 0 0 WL 02S 50-133-20375-90-00 2 951500 8 0 0 0 0 0 0 10 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. Printed Name: Jacob Owolabi Title: Production Analyst 4. Signature: Date: 4/16/2013 TOTAL 0 0 0 Form i 0-405 Rev. 1412005 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake APRIL 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 11 hereby certify that the foregoing is true and correct to the best of my knowledge. Signed 7ac� oGy-U-� ,6 0 0 0 Jacob Owolabi TOTAL OIL WATER GAS Title Production Analvst Date: 5/10/2013 STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC APRIL 2013 1. Well No. 2. API No. 3. Type 4. Field 5. Method 6. Days in Oper. 7. Avg. FTP DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION 8. OIL (BBL) 9. WATER (BBL) I 10. GAS (MCF) 1 11. OIL (BBL) I 12. WATER (BBL) I 13. GAS (MCF) 50-XXX-XXXXX-XX-XX (see instruct.) & Pool (see psig (see Code instruct.) instruct.) WL 01 RD 50-133-20362-01-00 1 2 951500 8 01 010 0 0 10 10 10 WL 02S 50-133-20375-90-00 1 2 1 951500 8 01 010 10 10 10 10 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Jacob Owolabi Title: Production Analyst Signature: J&� o[N-c� Date: 5/10/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake MAY 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed 1ar,'Cx6 ommwaha 0 0 Jacob Owolabi TOTAL OIL WATER Title Production Analyst Date: 6118/2013 GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC MAY 2013 1. Well No. 2. API No. 50-XXX-XXXXX-XX-XX 3. Type (see instruct.) 4. Field 5. Method & Pool (see Code instruct.) 6. Days in Oper. 7. Avg. FTP psig (see instruct.) DAILY AVG. PRODUCTION I TOTAL MONTHLY PRODUCTION 8. OIL (BBL) 9. WATER (BBL) 10. GAS (MCF) 11. OIL (BBL) 12. WATER 1 13. GAS (BBL) (MCF) WE 01 RD 50-133-20362-01-00 2 951500 1 8 1 0 00 10 12 0 0 lo WL 02S 50-133-20375-90-00 2 1 951500 1 8 1 0 0 0 10 0 0 0 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Jacob Owolabi Title: Production Analyst /' Signature: J aZ&b 014, rW l bL Date: 6/18/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES RECEIVED JUL 2 2 2013 AOGCC Hilcorp Alaska, LLC Wolf Lake JUNE 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed ��— OGV-U�0 0 Jacob Owolabi TOTAL OIL WATER Title Production Analyst Date: 7/16/2013 GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC JUNE 2013 1. Well No. 2. API No. 3. Type 50-XXX-XXXXX-XX-XX (see instruct.) 4. Field & Pool Code 5. Method (see instruct.) 6. Days in Oper. 7. Avg. FTP psig (see instruct.) DAILY AVG. PRODUCTION I TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER (BBL) (BBL) 10. GAS (MCF) 1 11. OIL (BBL) 1 12. WATER 1 13. GAS (BBL) (MCF) WL01RD 50-133-20362-01-00 2 951500 8 01 0 0 0 0 00 0 WL 02S 50-133-20375-90-00 2 951500 8 0 0 0 0 0 0 0 0 1 hereby certify that the foregoing is true and correct to the best of my knowledge. Printed Name: Jacob Owolabi Title: Production Analyst 14. Signature: %&CL4 Date: 7/16/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate Hilcorp Alaska, LLC Name of Operator Total Wells Total Wells Produced Total Pipeline Runs )sing Inventory ening Inventory ner Adjustments rect or xylene recovered) Net Production STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Wolf Lake Regulatory Lease I i I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed 'L� 0kvg&6� Jacob Owolabi Title Production Analyst Date: 8/19/2013 TOTAL OIL 0 RECEIVE® AUG 212013 JULY 2013 Month and Year of Production WATER 0 GAS 0 STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 RECEIVED AUG 212013 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: 1, A HILCORP ALASKA, LLC JULY 2013 1. Well No. 2. API No. 3. Type 4. Field 5. Method 6. Days in Oper. 7. Avg. FTP--F517-779-DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION WATER 10. GAS 11. OIL 12. WATER 13. GAS 50-XXX-XXXXX-XX-XX (see &Pool (see psig (see. instruct.) Code instruct.) instruct.) (BBL) (BBL) (MCF) IBBL) (BBL) (MCF) WL 01RD 50-133-20362-01-00 2 951500 8 1 0 0 0 10 10 10 j0-10 WL 02S 50-133-20375-90-00 2 951500 8 1 0 0 0 10 10 10 10 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Jacob Owolabi Title: Production Analyst Signature: Date: 8/19/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake AUGUST 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Pipeline Runs Ing Inventory ting Inventory r Adjustments ct or xylene recovered) Net Production I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed 7 cc' owt;'( r Jacob Owolabi Title Production Analyst Date: 9/19/2013 0 0 0 0 0 0 0 TOTAL OIL WATER GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION FACILITY REPORT OF PRODUCED GAS DISPOSITION 1. Facility Number 1330000030 2. Facility Name Wolf Lake 3. Field Wolf Lake 4. Operator Hilcorp Alaska.LLC 5. Month/Year of Disposition I August -13 Disposition Volume MCF 20. Forproduction from multiple pools, list contribution of each pool as a percent of Total Volume. 6. Sold 0 Pool Name Pool Code Percent 7. Reinjected 0 BEL-TYON UNDEF GAS 951500 8. Flared or vented 1 hour or less 0 9. Flared or vented more than 1 hour (see instr.) 0 10. Pilot and Purge 0 11. Assist Gas 0 12. Fuel gas used in lease operations. 0 13. Other (see instructions) 0 Official Use Only Authorization 11 hr. Safety MCF 14. TOTAL VOLUME (ITEMS 6-13) 0 Lease Use MCF 15. NGL Gas Equivalent 0 Conservation MCF 16. Purchased gas 0 Waste: MCF 17. Transferred from: 0 Commissioner Date 18. Transferred to: (Express as a negative #) 0 19. Remarks: I hereby certify that the foregoing is true and correct to the best of my knowledge. `_. j - f � Signature J c tf" Title Production Analyst Note: All volumes must be corrected to pressure of 14.65 psia and to a temperature of 60o F. Authority 20 AAC25.235. Printed Name Jacob Owolabi Phone 713-757-5227 Date 9/20/2013 Form 10-422 Rev. 5/2009 INSTRUCTIONS ON REVERSE SIDE Submit in Duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC AUGUST 2013 1. Well No. 2. API No. 3. Type 4. Field 5. Method 6. Days in Oper. 7. Avg. FTP DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER 10. GAS 11. OIL 12. WATER 13. GAS 50-XXX-XXXXX-XX-XX (see &Pool (see psig (see instruct.) Code instruct.) instruct.) (BBL) (BBL) (MCF) (BBL) (BBL) (MCF) WL 01RD 50-133-20362-01-002 951500 8 0 00 0 0 0 0 0 WL 02S 50-133-20375-90-00 2 951500 8 0 0 0 0 10 0 0 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Owolabii�,���%/,�, Title: Production Analyst �Jamb Signature: 7 okly . ��,� Date: 9/19/2013 TOTAL 0 0 0 Form 10-005 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Hilcorp Alaska, LLC Wolf Lake SEPTEMBER 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 1 hereby certify that the foregoing is true and correct to the best of my knowledge. Signed 'J&6'4 owa& jL 0 0 0 Jacob Owolabi TOTAL OIL WATER GAS Title Production Analyst Date: 10/17/2013 STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25.230 Name of Operator: Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: HILCORP ALASKA, LLC SEPTEMBER 2013 1. Well No. 2. API No. 50-XXX-XXXXX-XX-XX 3. Type (see instruct.) 4. Field & Pool Code 5. Method (see instruct.) 6. Days in Oper. 7. Avg. FTP psig (see instruct.) DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER (BBL) (BBL) 10. GAS 1 (MCF) 11. OIL 1 (BBL) 12. WATER (BBL) 13. GAS (MCF) WL 01RD 50-133-20362-01-00 2 951500 8 0 0 0 0 0 10 10 10 WL 02S 50-133-20375-90-00 2 951500 8 0 0 0 0 0 10 10 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. 14. Printed Name: Jacob OOwwolabi',r Title: Production Analyst Signature: 7`"""" ""' " "`""" Date: 10/17/2013 TOTAL 0 0 0 Form 10-405 Rev. 04/2006 INSTRUCTIONS ON REVERSE SIDE Submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SAI FS Hilcorp Alaska, LLC Wolf Lake OCTOBER 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Total Net Production 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed I&CC- oGV-�0 0 Jacob Owolabi TOTAL OIL WATER Title Production Analyst Date: 11/20/2013 GAS of STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 9n AA!` oc non -- - submit in duplicate STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NFT fill CAI FC Hilcorp Alaska, LLC Wolf Lake NOVEMBER 2013 Name of Operator Regulatory Lease Month and Year of Production Total Wells 2 Total Wells Produced 0 Total Pipeline Runs 0 Closing Inventory 0 Opening Inventory 0 Other Adjustments 0 (direct or xylene recovered) Net Production 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed `'ae-4 0m'-C4�� 0 0 Jacob Owolabi TOTAL OIL WATER Title Production Analyst Date: 12/16/2013 GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT 20 AAC 25 230 Name of Operator: HILCORP ALASKA, LLC Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: NOVEMBER 2013 1. Well No. 2. API No. 3. Type 50-XXX-XXXXX-XX-XX (see instruct.) 4. Field 8 Pool Code 5. Method (see instruct.) 6. Days in Oper. 7. Avg. FTP psig (see instruct.) DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION 8. OIL 9. WATER (BBL) (BBL) 10. GAS (MCF) 11. OIL 12. WATER 13. GAS (BBL) (BBL) (MCF) WL 01 RD 50-133-20362-01-00 2 WL 02S 50-133-20375-90-00 2 9515001 951500 8 1 8 0 0 0100 0 0 10 0 10 0 0 0 0 0 10 I hereby certify that the foregoing is true and correct to the best of my knowledge. Printed Name: Jacob Owolabi14. Title: Production Analyst ./ � � � �� / � � Signature: /� �lN'Pf�R.�(/ Date: 12/16/2013 Form 10-405 Rev. 04/2006 TOTAL 0 0 p ��•�„�vv �v���a VIV RCVCRSE SIDE Submit in duplicate Hilcorp Alaska, LLC Name of Operator Total Wells Total Wells Produced Total Pipeline Runs Closing Inventory Opening Inventory Other Adjustments (direct or xylene recovered) Net Production STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT NET OIL SALES Wolf Lake Regulatory Lease 2 0 I hereby certify that the foregoing is true and correct to the best of my knowledge. Signed lgcab Owvo 4� Jacob Owolabi Title Production Analyst Date: 1/18/2014 0 0 0 0 0 0 TOTAL OIL JAN 2 3 20; AOG( DECEMBER 2013 Month and Year of Production 0 WATER GAS STATE OF ALASKA ALASKA OIL AND GAS CONSERVATION COMMISSION MONTHLY PRODUCTION REPORT in nnr nc mon Name R Operator: HILCORP ALASKA, LLC Field and Pool: Wolf Lake, Wolf Lake, Bel-Tyon Undef Gas Month and Year: DECEMBER 2013 1. Well No. 2. API No. 50.XXX-XXXXX-XX-XX 3. Type (see 4. Field 5. Method & Pool 6. Days in Oper. 7. Avg. FTP DAILY AVG. PRODUCTION TOTAL MONTHLY PRODUCTION instruct.) (see Code instruct.) psig (see 8. OIL instruct.) (BBL) WATER 10. GAS (BBL) (MCF) 11. OIL 12. WATER 13. GAS (BBL) (BBL) (MCF) WL 01RD 50-133-20362-01-00 2 951500 8 0 0 0 0 WL 02S 50-133-20375-90-00 2 951500 8 0 0 0 0 0 0 0 0 0 0 0 0 I hereby certify that the foregoing Is true and correct to the best of my knowledge. Printed Name: Jacob Owclabi Title: Production Analyst 14. ��// Ol�l/"OY�, Signature:- ✓� Date: 1/18/2014 Form 10-405 Rev. 04!2006 inicToi 1,-TI.,.l� 1.1 .,..,.-...,� ....._ TOTAL 0 0 0 Submit in duplicate