REPORT OF WATER RIGHT CONVEYANCE
USE THIS CONVEYANCE REPORT FORM WHEN ONLY A PORTION OF THE WATER RIGHT IS CONVEYED.

Enter the Water Right number and click the "Get Water Right Info" button to verify pending change applications, non-use status, and grantor information.
Fill out this form, and then click the button to generate the printable form, then print the ROC 100% form from the resulting .pdf file.
If you would like to print a blank ROC PORTION form, simply leave the water right number field blank, and click the button to generate the printable ROC form.
If you leave the water right number field blank, a blank ROC form will be produced.

The Adobe reader is required to print the ROC form. It can be acquired at the following link.

This form has changed, please review carefully.
 
 
Water Right Number :   
 
Pending Change Applications : N/A
Under Non-Use : N/A
 
Water Right Total Interest Conveyed 
New Owner :
 
Mailing Address :
 
  City: State: Zip:
Email Address : (to be notified of ownership update)
 
Total Beneficial Uses Conveyed 
Water RightSole SupplyChange Appl. (if any)Sole Supply
Irrigation (acres)Irrigation (acres)
Stockwatering (ELUs)Stockwatering (ELUs)
Domestic (families)Domestic (families)
Municipal (ac ft)Municipal (ac ft)
Industrial (ac ft)Industrial (ac ft)
Other   (ac ft)Other   (ac ft)
Diversion Limit (acre feet)Diversion Limit (acre feet)
 
Retained by Previous Owner (Specify for each owner) 
Previous Owner :
 
Water RightSole SupplyChange Appl. (if any)Sole Supply
Irrigation (acres)Irrigation (acres)
Stockwatering (ELUs)Stockwatering (ELUs)
Domestic (families)Domestic (families)
Municipal (ac ft)Municipal (ac ft)
Industrial (ac ft)Industrial (ac ft)
Other   (ac ft) Other   (ac ft)
Diversion Limit (acre feet)Diversion Limit (acre feet)
Explanation of Conveyance/Special Conditions of Conveyance:  [0/1275 characters]
    
SECTION A. - CONVEYANCE SUMMARY #1
If no water right number is mentioned on deed, is a map attached? Yes No  
1. Deed Type :
Other Description
2. Date Signed :    Date Recorded :   
Book Number : Page Number :
Entry Number :
3. Grantor :
4. Portion of Beneficial Uses Conveyed : From Water RightFrom Pending Change Applications
 Sole Supply LimitSole Supply Limit
Irrigation : (acres) (acres)
Stockwatering : (ELUs) (ELUs)
Domestic : (families) (families)
Municipal : (ac ft) (ac ft)
Industrial : (ac ft) (ac ft)
Other : (ac ft) (ac ft)
5. Diversion Limit (acre-feet) :
6. Special Conditions/Information of Conveyance :
7. Grantee(s) :
8. Mailing Address :
9. E-mail Address :
This report is only to update ownership interest records.
If a change is desired in any other aspect of the water right, a change application must be filed.
SECTION B. - CERTIFICATION
I, , certify that I am authorized by Administrative Rule R655-3-7 to complete this report, and that the information contained herein or attached hereto is true and accuate to the best of my knowledge.
Date :          Phone Number :

I, , certify that I am licensed as
in the State of Utah, that my license number is , that I was retained by an owner of the water right to prepare or supervise the preparation of the Report of Conveyance; that the report is true and accurate to the best of the preparer's knowledge; that an appropriate search of County Recorder records has been made and that the attached documents evidence the ownership interest of the grantee.
Date :          Phone Number :
Address :
This report was prepared for the purpose of updating the records of the Division of Water Rights.
This report is not a title opinion based on a complete title search.
It does not warrant or guarantee title to water rights.
INSTRUCTIONS
There are five steps to this Report of Conveyance (ROC) form.

  1. Enter the Water Right number
  2. Click the "Get Water Right Info" button to verify pending change applications, non-use status, and grantor information
  3. Fill out this online form with all pertinent information.
  4. Click the "Generate Official ROC Form" button (found at the top right corner of the form).
  5. Print the resulting .pdf form.

The form on this page is for data input only, and is not intended to be accepted as the official form.

The Division of Water Rights will NOT accept a screen print of this data input form as an official ROC form.

You must fill out this form AND THEN CLICK THE "GENERATE THE OFFICIAL FORM" button to produce this form.

Report of Water Right Conveyance (ROC) fees are $85.00 plus $2.00 for each additional page over 15 pages, not to exceed $150.00.