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ion (optional): Sub-Basin: PCWILOG Due Date: PM Due Date: Page 1 of 6 EFTA00309074 4. COUNTY WHERE WATER RIGHT IS CL,..HENTLY USED (Required) Santa Fe 6. ADDITIONAL STATEMENTS CONCERNING THE CURRENT WATER RIGHT 6. CURRENT or MOVE-FROM POINT(S) OF DIVERSION (POD) (Required) O Surface POD OR 0.,

cation Required: Coordinate location must be reported in NM State Plane (NAD 83), UTM (NAD 83), or (Lid/Long - WGS84). II (Roswell) & District VII (Cimarron) customers, provide a PLSS location in addition to above. State Plane (NAO83) (Feet) O UTM (NAD83) (Meters) O Lat/Long (WGS84) (to the nearest NM

elp to clarify this water right transfer. Assistance in completing this form is available, and the form may be filed at the State Engineer Office in Santa Fe and the District Offices located as follows: District 1 5550 San Antonio Drive NE Albuquer ue. NM 87109-4127 Phone # District 2 1900 West Seco

g. NM 88031-0844 Phone # District 4 District 7 1680 Hickory Loop, Suite J 301 East 9th Street Las Cruces. NM 88005-6598 P.O. Box 481 Phone # Cimarron, NM 87714 Phone #=IIM District 5 100 Gossett Drive, Suite A Aztec. NM 87410 Phone # District 6 407 Galisteo Street Room 102, Bataan Memorial

22-6521 District 3 301 South Tin. M. Box 844 Deming. NM 88031-0844 Phone # 575-546-2851 nd the form may be filed at the State Engineer Office in Santa Fe and the District Offices located District 4 District 7 1680 Hickory Loop. Suite J Las Cruces. NM 88005-6598 Phone # 575-524-6161 District 5 10

6 407 Galisteo Street Room 102. Bataan Memorial Building M. Box 25102 Santa Fe. NM 87504-5102 Phone # 505-827-6120 301 East e Street Box 481 Cimarron, NM 87714 Phone # 575-376-2918 EFTA00298503