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Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 19-févr.-14- Page 1 of 11
1- IDENTIFICATION OF THE TRANSFERORName of the enterprise Enterprise number
☐ ENTREPRISE
Name First name Function Designated representative:
or Name First name Date of birth
☐ INDIVIDUAL
Address (number, street, rural route or P.O. box) Apt. City, town or municipality
Province Country Postal code Area code telephone (cellular) Area code telephone (office) Extension
Area code facsimile Email address
2- IDENTIFICATION OF TRANSFEREEName of the enterprise Enterprise number
☐ ENTREPRISE
Name First name Function Designated representative:
or Name First name Date of birth
☐ INDIVIDUAL
Address (number, street, rural route or P.O. box) Apt. City, town or municipality
Province Country Postal code Area code telephone (cellular) Area code telephone (office) Extension
Area code facsimile Email address
3- LISTE OF SHARES TO TRANSFER
The transferor transfers to the transferee a share of the transferor’s rights in the licences listed below:
LICENCES COVERED BY THE TRANSFER
Number of the licence
Date of Issuance Area Current share
Share to transfer
The wells that are not permanently closed, that are under the transferor’s responsibility, and that are not included in the transaction, please contact the Ministère de l’Énergie et des Ressources naturelles for information about the procedure.
Application to transfer a share Petroleum Resources Act (CQLR, chapter H-4.2)
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 2 of 11
4- DOCUMENTS TO ATTACH
The list of documents to attach to this transfer application is included in annex 2.
5- SIGNATURE
TRANSFEROR
☐ ENTREPRISE
I, the undersigned, , (the transferor’s designated representative), state that the transferor has not failed to respect the transferor’s obligations under the Petroleum Resources Act or its related regulations (section 110 of the Regulation respecting petroleum exploration, production and storage licences, and the pipeline construction or use authorization [CQLR, chapter H-4.2, r. 3; hereinafter “Regulation”]).
Signed at this day of 20 .
Signature: .
Witness:
Signed at this day of 20 .
Name (block letters): .
Signature: .
☐ INDIVIDUAL
I, the undersigned, , (transferor), state that I have not failed to respect my obligations under the Petroleum Resources Act or its related regulations (section 110 of the Regulation).
Signed at this day of 20 .
Signature: .
Witness:
Signed at this day of 20 .
Name (block letters): .
Signature: .
TRANSFEREE
☐ ENTREPRISE
I, the undersigned, , (the transferee’s designated representative), state that the transferee’s licence or share of licence has not been revoked in the last five years (section 111 of the Regulation).
Signed at this day of 20 .
Signature: .
Witness:
Signed at this day of 20 .
Name (block letters): .
Signature: .
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 3 of 11
☐ INDIVIDUAL
I, the undersigned, , (the transferee), state that my licence or share of licence has not been revoked in the last five years (section 111 of the Regulation).
Signed at this day of 20 .
Signature: .
Witness:
Signed at this day of 20 .
Name (block letters): .
Signature: .
For departmental use only
__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
______________ Date of receipt
Registration fees (section 173 of the
Regulation)
Number of registrations _______ $
Registrar’s Seal
Signature of authorized person
Remember that the transferee has the obligation to inform the owners or lessees, local municipalities and the regional county municipalities of the transfer once the transfer is completed (section 115 of the Regulation), in accordance with the terms of the Regulation (section 5 of the Regulation).
Also remember that the transferee must comply with the provision regarding the monitoring committee as stated in Chapter II of Division II of the Regulation.
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 4 of 11
ANNEX 1 List of ceded wells
On a transferred licence, the transferee must apply for a drilling authorization for each well that is not permanently closed (section 113 of the Regulation). These wells must be listed in the table below:
Licence number: Number of wells Status
Licence number: Number of wells Status
Licence number: Number of wells Status
Licence number: Number of wells Status
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 5 of 11
ANNEX 2 List of wells to be permanently closed
On a transferred licence, the transferee must apply for a permanent closure authorization for each well that is not permanently closed. These wells must be listed in the table below:
Licence number: Number of wells Status
Licence number: Number of wells Status
Licence number: Number of wells Status
Licence number: Number of wells Status
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 6 of 11
ANNEX 3 Documents to attach to the application to transfer a share1 A- In the case of a full transfer of a share without wells, the transfer application must be accompanied by: ☐ The form (section 112 paragraph 1 of the Regulation respecting petroleum exploration, production and storage licences, and
the pipeline construction or use authorization [CQLR, chapter H-4.2, r. 3; hereinafter: “RPEPSLPCU”]). ☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transferee
by requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU). ☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an update
of the summary of the work requested under subsection 33(4) of the RPEPSLPCU 2 (section 112 paragraph 2 RPEPSLPCU). ☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update of
the proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency [subsection 116(2) RPEPSLPCU)].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU). ☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment process
to the Minister for approval (section 114 RPEPSLPCU). ☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Petroleum Resources
Act; hereinafter: “Act”). ☐ A payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real and
immovable rights (subsection 173(1) RPEPSLPCU). B- In the case of a partial transfer of a share without wells, the transfer application must be accompanied by: ☐ The form (section 112 paragraph 1 RPEPSLPCU). ☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transferee
by requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU). ☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an update of the summary of the work requested under subsection 33(4) of the RPEPSLPCU3 (section 112 paragraph 2 RPEPSLPCU). ☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update of
the proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency [subsection 116(2) RPEPSLPCU)].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU). ☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment process
to the Minister for approval (section 114 RPEPSLPCU). ☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Act). ☐ A payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real and
immovable rights (subsection 173(1) RPEPSLPCU).
1 100% of a share from the transferor to the transferee (complete transfer of a share) or a certain percentage of a share from the transferor to the transferee
(partial transfer of a share) 2 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2). 3 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2).
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 7 of 11
C- In the case of a full transfer of a share with wells that are not permanently closed, of which only some will betransferred, the transfer application must be accompanied by:4
☐ The form (section 112 paragraph 1 RPEPSLPCU).
☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transferee by requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU).
☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an updateof the summary of the work requested under subsection 33(4) of the RPEPSLPCU5 (section 112 paragraph 2 RPEPSLPCU).
☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update ofthe proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency[subsection 116(2) RPEPSLPCU].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU).
☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment processto the Minister for approval (section 114 RPEPSLPCU).
☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Act).
☐ A payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real andimmovable rights (subsection 173(1) RPEPSLPCU).
☐ Ensure that the transferred wells are indeed owned by the transferor.
☐ Application by the transferor to be released from those obligations related to the closure plan and to the guarantee(section 112 Act).
☐ Payment to the order of the “Ministère des Finances du Québec” of the assessment fee for the purpose of issuing the certificateof release in the amount indicated in section 323 of the Regulation respecting petroleum exploration, production and storageon land (CQLR, chapter H-4.2, r. 2; hereinafter: “RPEPSL”).
☐ An application by the transferee for drilling authorization (section 113 RPEPSLPCU).
☐ Payment to the order of the “Ministère des Finances du Québec” for the fees to issue the drilling authorization in the amountindicated in subsection 122(5) RPEPSL).
☐ If the transferee keeps the transferor’s closure plan, the plan must be signed and sealed by an engineer hired by the transferee.
☐ If the transferee does not keep the transferor’s closure plan, a new closure plan must be sent by the transferee(section 101 Act).
☐ Payment to the order of the “Ministère des Finances du Québec” by the transferee for the assessment fee, in the amountindicated in section 322 paragraph 1 RPEPSL, for the closure plan if a new plan is filed by the transferee.
☐ Whether or not the transferee uses the transferor’s plan or files a new plan, a new guarantee for the plan filed by the transfereeto permanently close the well or reservoir and to restore the site (section 103 Act and sections 317 et seq. RPEPSL).
If wells must be permanently closed before the transfer, the transfer application must be accompanied also attach to the application:
☐ An update of permanent well or reservoir closure and site restoration plan, if applicable.
☐ The payment to the order of the “Ministère des Finances du Québec” for the assessment fee, in the amount indicated insection 322 paragraph 2 RPEPSL, for the revision of a permanent well or reservoir closure and site restoration plan, ifapplicable.
☐ An update of the guarantee for the permanent well plan (section 103 Act).
☐ A permanent closure authorization by the licence holder (see checklist for such a request).
4 The wells that are not permanently closed and that are not transferred must be permanently closed before the transfer may be processed. 5 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2).
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 8 of 11
When the work of permanent closure of the well will be completed, the following documents must be sent:
☐ A certificate of an expert (section 113 Act).
☐ A proof of registering in the land register a declaration of the closure (section 98 Act).
☐ The payment to the order of the “Ministère des Finances du Québec” for the assessment fee for the inspections conductedfor the purpose of issuing a certificate of release (section 323 paragraph 2 RPEPSL).
D- In the case of a partial transfer of a share with wells that are not permanently closed, of which some will be transferred,the transfer application must be accompanied by:6
☐ The form (section 112 paragraph 1 RPEPSLPCU).
☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transfereeby requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU).
☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an updateof the summary of the work requested under subsection 33(4) of the RPEPSLPCU by the transferee7 (section 112 paragraph 2RPEPSLPCU).
☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update ofthe proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency[subsection 116(2) RPEPSLPCU)].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU).
☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment processto the Minister for approval (section 114 RPEPSLPCU).
☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Act).
☐ A payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real andimmovable rights (subsection 173 (1) RPEPSLPCU).
☐ Ensure that the transferred wells are indeed owned by the transferor.
☐ An application by the transferor to be released from these obligations related to the closure plan and to the guarantee(section 112 Act).
☐ Payment to the order of the “Ministère des Finances du Québec” of the assessment fee for the purpose of issuing the certificateof release in the amount indicated in section 323 paragraph 1 RPEPSL).
☐ An application by the transferee for drilling authorization (section 113 RPEPSLPCU).
☐ Payment to the order of the “Ministère des Finances du Québec” for the fees to issue the drilling authorization in the amountindicated in subsection 122(5) RPEPSL).
☐ If the transferee keeps the transferor’s closure plan, the plan must be signed and sealed by an engineer hired by the transferee.
☐ If the transferee does not keep the transferor’s closure plan, a new closure plan must be sent by the transferee(section 101 Act).
☐ Payment to the order of the “Ministère des Finances du Québec” by the transferee for the assessment fee, in the amountindicated in section 322 paragraph 1 RPEPSL, for the closure plan if a new plan is filed by the transferee.
☐ Whether or not the transferee uses the transferor’s plan or files a new plan, a new guarantee for the plan filed by the transfereeto permanently close the well or reservoir and to restore the site (section 103 Act and sections 317 et seq. RPEPSL).
6 Supra, note 4.
7 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2).
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 9 of 11
If wells must be permanently closed before the transfer, the transfer application must be accompanied also attach to the application: ☐ An update of permanent well or reservoir closure and site restoration plan, if applicable. ☐ The payment to the order of the “Ministère des Finances du Québec” for the assessment fee, in the amount indicated in
section 322 paragraph 2 RPEPSL, for the revision of a permanent well or reservoir closure and site restoration plan, if applicable.
☐ An update of the guarantee for the permanent well plan (section 103 Act). ☐ A permanent closure authorization by the licence holder (see checklist for such a request). When the work of permanent closure of the well will be completed, the following documents must be sent: ☐ A certificate of an expert (section 113 Act). ☐ A proof of registering in the land register a declaration of the closure (section 98 Act). ☐ The payment to the order of the “Ministère des Finances du Québec” for the assessment fee for the inspections conducted
for the purpose of issuing a certificate of release (section 323 paragraph 2 RPEPSL). E- In the case of the full transfer of a share with wells that are not permanently closed, of which only some will be transferred, the transfer application must be accompanied by: ☐ The form (section 112 paragraph 1 RPEPSLPCU). ☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transferee
by requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU). ☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an
update of the summary of the work requested under subsection 33(4) of the RPEPSLPCU by the transferee8 (section 112 paragraph 2 RPEPSLPCU).
☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update of
the proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency [subsection 116(2) RPEPSLPCU].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU). ☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment process
to the Minister for approval (section 114 RPEPSLPCU). ☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Act). ☐ Payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real and
immovable rights (subsection 173 (1) RPEPSLPCU). ☐ Ensure that the transferred wells are indeed owned by the transferor. ☐ An application by the transferor to be released from these obligations related to the closure plan and to the guarantee
(section 112 Act). ☐ Payment to the order of the “Ministère des Finances du Québec” of the assessment fee for the purpose of issuing the certificate
of release in the amount indicated in section 323 paragraph 1 RPEPSL). ☐ An application by the transferee for drilling authorization (section 113 RPEPSLPCU). ☐ Payment to the order of the “Ministère des Finances du Québec” for the fees to issue the drilling authorization in the amount
indicated in subsection 122(5) RPEPSL). ☐ If the transferee keeps the transferor’s closure plan, the plan must be signed and sealed by an engineer hired by the transferee. ☐ If the transferee does not use the transferor’s closing plan, a new closing plan filed by the transferee (section 101 Act).
8 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2).
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 10 of 11
☐ Payment to the order of the “Ministère des Finances du Québec” by the transferee for the assessment fee, in the amount indicated in section 322 paragraph 1 RPEPSL, for the closure plan if a new plan is filed by the transferee.
☐ Whether or not the transferee uses the transferor’s plan or files a new plan, a new guarantee for the plan filed by the transferee
to permanently close the well or reservoir and to restore the site (section 103 Act and sections 317 et seq. RPEPSL). F- In the case of the full transfer of a share with wells that are not permanently closed, of which only some will be transferred, the transfer application must be accompanied by: ☐ The form (section 112 paragraph 1 RPEPSLPCU). ☐ If the transferee is not already the holder or joint holder of a licence, verify the technical and financial capability of that transferee
by requesting the transferee’s:
most recent annual financial statements verified by an independent auditor; main fields of activity; area of specialization; experience; and main achievements.
☐ New proof of solvency by the transferee (section 112 paragraph 2 RPEPSLPCU). ☐ In the case of a transfer of an exploration licence for which the transferor was in charge of the exploration program, an update
of the summary of the work requested under subsection 33(4) of the RPEPSLPCU by the transferee9 (section 112 paragraph 2 RPEPSLPCU).
☐ In the event that the transferee acquires the majority of the shares in the exploration, production or storage right, an update of
the proof of solvency provided for in section 165 RPEPSLPCU if the transferor was responsible for the proof of solvency [subsection 116(2) RPEPSLPCU].
☐ The designation of a representative with the Minister if there is a change (subsection 116(3) RPEPSLPCU). ☐ In the event that the transferee wishes to change the composition of the monitoring committee, a new appointment process
to the Minister for approval (section 114 RPEPSLPCU). ☐ The report of the minimum work realized under the licence (equivalent of 2nd paragraph of the section 31 Act). ☐ Payment to the order of the “Ministère des Finances du Québec” to register each licence on the Public register of real and
immovable rights (subsection 173 (1) RPEPSLPCU). ☐ Ensure that the transferred wells are indeed owned by the transferor. ☐ An application by the transferor to be released from these obligations related to the closure plan and to the guarantee
(section 112 paragraph 2 Act). ☐ Payment to the order of the “Ministère des Finances du Québec” of the assessment fee for the purpose of issuing the certificate
of release in the amount indicated in section 323 paragraph 1 RPEPSL). ☐ An application by the transferee for drilling authorization (section 113 RPEPSLPCU). ☐ Payment to the order of the “Ministère des Finances du Québec” for the fees to issue the drilling authorization in the amount
indicated in subsection 122(5) RPEPSL). ☐ If the transferee keeps the transferor’s closure plan, the plan must be signed and sealed by an engineer hired by the transferee. ☐ If the transferee does not use the transferor’s closing plan, a new closing plan filed by the transferee (section 101 Act). ☐ Payment to the order of the “Ministère des Finances du Québec” by the transferee for the assessment fee, in the amount
indicated in section 322 paragraph 1 RPEPSL, for the closure plan if a new plan is filed by the transferee. ☐ Whether or not the transferee uses the transferor’s plan or files a new plan, a new guarantee for the plan filed by the transferee
to permanently close the well or reservoir and to restore the site (section 103 Act and sections 317 et seq. RPEPSL).
9 Not currently required based on section 285 of the Petroleum Resources Act (CQLR, chapter H-4.2).
Ministère de l’Énergie et des Ressources naturelles Direction du bureau des hydrocarbures 17-01-05 - Page 11 of 11
ANNEX 4 Rights and obligations subject to the transfer
Any exploration licence transferred in accordance with this form includes the transfer of rights and obligations associated with that licence, i.e. those set out in sections 15 and 25 to 40 of the Petroleum Resources Act (CQLR, chapter H-4.2), as well as its implementing regulations.
Any production licence transferred in accordance with this form includes the transfer of rights and obligations associated with that licence, i.e. those set out in sections 15 and 51 to 64 of the Petroleum Resources Act (CQLR, chapter H-4.2), as well as its implementing regulations.
Any storage licence transferred in accordance with this form includes the transfer of rights and obligations associated with that licence, i.e. those set out in sections 15, 51 to 61 and 65 à 67 of the Petroleum Resources Act (CQLR, chapter H-4.2), as well as its implementing regulations.