Statement of Interest Form

Fill out this form, and then click the button to generate the printable form, then print the Statement of Interest form from the resulting .pdf file.

First Name :
Last Name :
Water Right Number(s) :
Designated Representative (if applicable) :
Street Address :
City :
State :
Zip Code :

I choose to receive further notice in this action by :

Please select a mail preferenceE-mailUS Mail   My e-mail address is :

This Statement of Interest will not change the address of record on the State Engineer's water right files.

I request that the Division of Water Rights send me a change of address form for my water rights

(the form is also available on the Division of Water Rights web site at this link.)