This is the approved form for the purpose of section 66F of the Petroleum and Greenhouse Gas Pipelines Act 1969.
Note: this form can only be used for the full surrender of a petroleum or greenhouse gas (GHG) pipeline licence. To partially surrender a petroleum or GHG pipeline licence, ensure that the relevant approved form is completed.
Submission of application
The application, together with supporting data must be submitted online through the Petroleum and Geothermal Register (PGR).
If you require assistance in completing this form, please contact the Resource Tenure Division by email to petroleum.titles@dmpe.wa.gov.au
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