Propane, Liquefied Gas, Compressed Gas Forms

Updated: 03/07/13

Copies can be obtained from the Austin office. For clarification purposes, these forms have been grouped together. CNG forms are designated by a 1000 number and LNG forms are designated by 2000 numbers. All forms must be completed properly prior to submission. Incomplete forms will be returned.

Note: All forms are in PDF format and you can download the PDF Reader from Adobe at http://www.adobe.com.

LPG Forms

Form Number	Form Title	PDF Form	PDF Fill-In Form
LPG Form 1	Application for LPG License or License Renewal
LPG Form 1A	Outlet List
LPG Form 7	Truck Registration/Re-registration/Transfer
LPG Form 8	Manufacturer’s Report of Pressure Vessel Repair, Modification, or Testing
LPG Form 8A	Report of DOT Cylinder Repair
LPG Form 16	Application for Examination
LPG Form 16A	Certified Employee Transfer Form
LPG Form 16B	Application for Registration by a Master or Journeyman Plumber or a Class
LPG Form 16R	Application for LP-Gas Examination Exemption by Reciprocity Agreement
LPG Form 18	Affidavit of Lost or Destroyed License
LPG Form 18B	Statement of Lost or Destroyed LPG Form 4 Decal
LPG Form 19	Transfer of LP-Gas Bulk Storage Plant or Cylinder Filling/Service Station
LPG Form 20	Report of LP-Gas Incident/Accident
LPG Form 22	Report of LP-Gas Safety Rule Violation
LPG Form 23	Statement in Lieu of Container Testing
LPG Form 25	Application and Notice of Exception to the LP- Gas Safety Rules
LPG Form 28	Notice of Election to Self-Insure
LPG Form 28A	Bank Declarations Regarding Irrevocable Letter of Credit
LPG Form 30	Texas School LP-Gas Leakage Test Report
LPG Form 500	Application to Install LPG Facility (Aggregate Water Capacity of 10,000 Gallons or More)
LPG Form 500A	Notice of Proposed LP-Gas Installation
LPG Form 501	Completion Report for LP-Gas Installations of Less than 10,000 Gallons Aggregate Water Capacity
LPG Form 502	Application for Commission Identification Nameplate Installation
LPG Form 503	Notice of Completed Installation of an LP-Gas System on School Bus, Public Transportation, Mass Transit, or Special Transit Vehicle(s)
LPG Form 505	Testing Procedures Certification
LPG Form 506	Polyethylene Pipe/Tubing Heat-Fusion Certification
LPG Form 995	Certification of Political Subdivision of Self-Insurance for Workers’ Compensation, General Liability, and/or Motor Vehicle Liability Insurance
LPG Form 996B	Statement in Lieu of Insurance Filing Certifying Workers’ Compensation Coverage, including Employer’s Liability Insurance or Alternative Accident/Health Insurance
LPG Form 997B	Statement in Lieu of Motor Vehicle Bodily Injury Insurance and Property Damage Liability Insurance
LPG Form 998B	Statement in Lieu of General Liability Insurance and/or Completed Operations or Products Liability Insurance
LPG Form 999	Notice of Insurance Cancellation
ACORD	Certificate of General Liability, Automobile Liability and Workers Compensation Coverage

CNG Forms

Form Number	Form Title	PDF Form	PDF Fill-In Form
CNG Form 1001	Application for CNG License or License Renewal
CNG Form 1001A	Branch Outlet List
CNG Form 1007	Truck Registration/Re-registration/Transfer
CNG Form 1008	Manufacturer’s Report of Retest or Repair
CNG Form 1016	Application for Examination
CNG Form 1016A	Certified Employee Transfer Form
CNG Form 1016B	Application for Registration by a Master or Journeyman Plumber or a Class A or B Air Conditioning & Refrigeration Contractor
CNG Form 1018	Affidavit of Lost or Destroyed License
CNG Form 1018B	Statement of Lost or Destroyed CNG Form 1004 Decal
CNG Form 1019	Transfer of CNG Storage Cylinders/Containers
CNG Form 1020	Report of CNG Incident/Accident
CNG Form 1025	Application and Notice of Exception to the Regulations for Compressed Natural Gas
CNG Form 1027	Application for Qualification as Self-Insurer General Liability
CNG Form 1028	Notice of Election to Self-Insure
CNG Form 1500	Application to Install CNG Facility (Aggregate Storage Capacity Greater than 240 Standard Cubic Feet Water Volume)
CNG Form 1501	Completion Report for CNG Commercial Installations of 240 Standard Cubic Feet Water Volume or Less
CNG Form 1503	Notice of Completed Installation of a CNG System on School Bus, Public Transportation, Mass Transit, or Special Transit Vehicle(s)
CNG Form 1505	Testing Procedures Certification
CNG Form 1995	Certification of Political Subdivision of Self-Insurance for Workers’ Compensation, General Liability, and/or Motor Vehicle Liability Insurance
CNG Form 1996B	Statement in Lieu of Insurance Filing Certifying Workers’ Compensation Coverage, including Employer’s Liability Coverage or Alternative Accident/Health Insurance
CNG Form 1997B	Statement in Lieu of Motor Vehicle Bodily Injury Insurance and Property Damage Liability Insurance
CNG Form 1998B	Statement in Lieu of General Liability Insurance and/or Completed Operations or Products Liability Insurance
CNG Form 1999	Notice of Insurance Cancellation

LNG Forms

Form Number	Form Title	PDF Form	PDF Fill-In Form
LNG Form 2001	Application for LNG License or License Renewal
LNG Form 2001A	Branch Outlet List
LNG Form 2007	Truck Registration/Re-registration/Transfer
LNG Form 2008	Manufacturer’s Report of Pressure Vessel Repair, Modification, or Testing
LNG Form 2016	Application for Examination
LNG Form 2016A	Certified Employee Transfer Form
LNG Form 2018	Affidavit of Lost or Destroyed License
LNG Form 2018B	Statement of Lost or Destroyed LNG Form 2004 Decal
LNG Form 2019	Transfer of LNG Storage Cylinders/Containers
LNG Form 2020	Report of LNG Incident/Accident
LNG Form 2025	Application and Notice of Exception to the Regulations for Liquefied Natural Gas
LNG Form 2027	Application for Qualification as Self-Insurer General Liability
LNG Form 2028	Notice of Election to Self-Insure
LNG Form 2500	Application to Install LNG Facility (Aggregate Water Capacity of 15,540 Gallons or More)
LNG Form 2500A	Notice of Proposed LNG Installation
LNG Form 2501	Completion Report for Commercial LNG Installations of Less Than 15,540 Gallons Water Capacity
LNG Form 2503	Notice of Completed Installation of an LNG System on School Bus, Public Transportation, Mass Transit, or Special Transit Vehicles
LNG Form 2505	Testing Procedures Certification
LNG Form 2995	Certification of Political Subdivision of Self-Insurance for Workers’ Compensation, General Liability, and/or Motor Vehicle Liability Insurance
LNG Form 2996B	Statement in Lieu of Insurance Filing Certifying Workers’ Compensation Coverage, including Employer’s Liability Insurance or Alternative Accident/Health Insurance
LNG Form 2997B	Statement in Lieu of Motor Vehicle Bodily Injury and Property Damage Liability Insurance
LNG Form 2998B	Statement in Lieu of General Liability Insurance and/or Completed Operations or Products Liability Insurance
LNG Form 2999	Notice of Insurance Cancellation