INSTRUCTIONS FOR 4211: ANNUAL GROSS PRODUCTS TAKE IN ...
INSTRUCTIONS FOR 4211: ANNUAL GROSS PRODUCTS TAKE IN-KIND BALANCE SHEET FOR GAS
COMPLETE 4111 AND ATTACH TO 4101 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND WHO ELECT TO REPORT ON THEIR OWN BEHALF. (Note, ASCII filers report all TIK on 4111.) PRODUCTION YEAR: calendar year in which production occurred. TAXPAYER INFORMATION SECTION: Operator ID - Taxpayer's Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division of the Wyoming Department of Revenue. Taxpayer - Taxpayer's name. NOT a tax agent. PRODUCING ASSET SECTION: Reporting Group Number - the Reporting Group number assigned to the producing asset by the Mineral Tax Division. Reporting Group Name - Name of the producing asset. B. TAKE IN-KIND INTEREST OWNER VOLUME INFORMATION Enter the name of each take in-kind interest owner who is reporting on their own behalf and the volume taken. Enter the TIK Operator ID. Contact the Mineral Tax Division if the TIK Operator ID is unknown. Page Total - Enter the total volume taken here and on 4101 Section D, Line 5d.
INSTRUCTIONS FOR 4211: ANNUAL GROSS PRODUCTS TAKE IN-KIND BALANCE SHEET FOR GAS
COMPLETE 4211 AND ATTACH TO 4201 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND WHO ELECT TO REPORT ON THEIR OWN BEHALF. (Note, ASCII filers report all TIK on 4211.) PRODUCTION YEAR: calendar year in which production occurred. TAXPAYER INFORMATION SECTION: Operator ID - Taxpayer's Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division of the Wyoming Department of Revenue. Taxpayer - Taxpayer's name. NOT a tax agent. PRODUCING ASSET SECTION: Reporting Group Number - the Reporting Group number assigned to the producing asset by the Mineral Tax Division. Reporting Group Name - Name of the producing asset. B. TAKE IN-KIND INTEREST OWNER VOLUME INFORMATION Enter the name of each take in-kind interest owner who is reporting on their own behalf and the volume taken. Enter the TIK Operator ID. Contact the Mineral Tax Division if the TIK Operator ID is unknown. Page Total - Enter the total volume taken here and on 4201 Section C, Line 4d.
rev. 12/5/2000
Gross Products Tax Reporting Instructions State of Wyoming Department of Revenue 122 West 25th Street Cheyenne, WY 82002-0110
4211
Production Year: __ __ __ __ PRODUCING ASSET
TAXPAYER INFORMATION Operator ID
!"#$$!%
ANNUAL GROSS PRODUCTS TAKE IN-KIND BALANCE SHEET FOR GAS
Revenue Use Only
Calendar year in which production occurred.
Taxpayer
Reporting Group Number
Reporting Group Name
B. Take In-Kind Interest Owner Volume Information TIK Interest Owner Name TIK Operator ID Taxpayer’s Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division. Taxpayer’s name. Do not enter an agent’s name here.
Volume Taken
Reporting Group Name The Reporting Group Number assigned by the Mineral Tax Division
Enter the volume taken. Enter the name of each take in-kind interest owner who is reporting on their own behalf
Enter the Operator ID of each take in-kind interest owner. Contact the Mineral Tax Division if the Operator ID is unknown.
COMPLETE FORM 4211 AND ATTACH TO FORM 4201 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND.
Enter the total volume taken here and on Form 4201 Section C Line 4d. Page Total (Enter here and on 4201, Section C, Line 4d)
I declare under penalty of perjury that I have examined this return, and , to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
MTS2 1216/99
Date Form 4211 page 1
!"#$$!
COMPLETE 4111 AND ATTACH TO 4101 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND WHO ELECT TO REPORT ON THEIR OWN BEHALF. (Note, ASCII filers report all TIK on 4111.) PRODUCTION YEAR: calendar year in which production occurred. TAXPAYER INFORMATION SECTION: Operator ID - Taxpayer's Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division of the Wyoming Department of Revenue. Taxpayer - Taxpayer's name. NOT a tax agent. PRODUCING ASSET SECTION: Reporting Group Number - the Reporting Group number assigned to the producing asset by the Mineral Tax Division. Reporting Group Name - Name of the producing asset. B. TAKE IN-KIND INTEREST OWNER VOLUME INFORMATION Enter the name of each take in-kind interest owner who is reporting on their own behalf and the volume taken. Enter the TIK Operator ID. Contact the Mineral Tax Division if the TIK Operator ID is unknown. Page Total - Enter the total volume taken here and on 4101 Section D, Line 5d.
INSTRUCTIONS FOR 4211: ANNUAL GROSS PRODUCTS TAKE IN-KIND BALANCE SHEET FOR GAS
COMPLETE 4211 AND ATTACH TO 4201 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND WHO ELECT TO REPORT ON THEIR OWN BEHALF. (Note, ASCII filers report all TIK on 4211.) PRODUCTION YEAR: calendar year in which production occurred. TAXPAYER INFORMATION SECTION: Operator ID - Taxpayer's Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division of the Wyoming Department of Revenue. Taxpayer - Taxpayer's name. NOT a tax agent. PRODUCING ASSET SECTION: Reporting Group Number - the Reporting Group number assigned to the producing asset by the Mineral Tax Division. Reporting Group Name - Name of the producing asset. B. TAKE IN-KIND INTEREST OWNER VOLUME INFORMATION Enter the name of each take in-kind interest owner who is reporting on their own behalf and the volume taken. Enter the TIK Operator ID. Contact the Mineral Tax Division if the TIK Operator ID is unknown. Page Total - Enter the total volume taken here and on 4201 Section C, Line 4d.
rev. 12/5/2000
Gross Products Tax Reporting Instructions State of Wyoming Department of Revenue 122 West 25th Street Cheyenne, WY 82002-0110
4211
Production Year: __ __ __ __ PRODUCING ASSET
TAXPAYER INFORMATION Operator ID
!"#$$!%
ANNUAL GROSS PRODUCTS TAKE IN-KIND BALANCE SHEET FOR GAS
Revenue Use Only
Calendar year in which production occurred.
Taxpayer
Reporting Group Number
Reporting Group Name
B. Take In-Kind Interest Owner Volume Information TIK Interest Owner Name TIK Operator ID Taxpayer’s Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division. Taxpayer’s name. Do not enter an agent’s name here.
Volume Taken
Reporting Group Name The Reporting Group Number assigned by the Mineral Tax Division
Enter the volume taken. Enter the name of each take in-kind interest owner who is reporting on their own behalf
Enter the Operator ID of each take in-kind interest owner. Contact the Mineral Tax Division if the Operator ID is unknown.
COMPLETE FORM 4211 AND ATTACH TO FORM 4201 IF THERE ARE MORE THAN THREE INTEREST OWNERS TAKING PRODUCTION IN-KIND.
Enter the total volume taken here and on Form 4201 Section C Line 4d. Page Total (Enter here and on 4201, Section C, Line 4d)
I declare under penalty of perjury that I have examined this return, and , to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
MTS2 1216/99
Date Form 4211 page 1
!"#$$!
