INSTRUCTIONS FOR FORM 3000: SEVERANCE TAX REPORT GAS
INSTRUCTIONS FOR FORM 3000: SEVERANCE TAX REPORT GAS
USE Form 3000 TO REPORT GAS AND PLANT PRODUCTS INCLUDING PLANT CONDENSATE (liquids separated at a processing plant). REPORT ALL VOLUMES AND VALUES (EXCEPT TAX FIELDS) ROUNDED TO THE NEAREST WHOLE NUMBER. TAX MUST BE REPORTED TO THE CENT. Operator ID – Enter the 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. Form Type -
Enter "O" for an Original Report. Enter "A" for an Amended Report.
Taxpayer Name – Enter Taxpayer's name. Do not enter a tax agent. Contact Name - Enter the name of the person who can answer questions about this form. Contact Phone Number - Enter the Contact person’s phone number. Production Period - Month and year (mmyyyy). If you qualify as an annual filer, report production for the entire year on one line as December (12yyyy). Reporting Group Number - Enter the five digits Reporting Group Number assigned by the Mineral Tax Division. Rate Code - Enter the proper rate code identifier for the Reporting Group (see Rate Code Table). Form 3000 is used to enter the combined Rate Code total for a specific Reporting Group. Individual wells in a Reporting Group that qualify for well incentives must also be itemized on Form 3002, Severance Tax Schedule Gas Well Incentive Reporting. Gross Sales Volume - Operators, enter gross MCF sold, after deducting gross MCF taken in-kind by interest owners who are reporting on their own behalf. Take in-kind interest owners enter gross MCF taken in-kind. Gross Sales Value - Enter the gross sales value for the production period. Gross Sales Value includes all revenue relating to the production for the reported period, including tax reimbursements and all other revenue received or credited to all interest owners not taking in-kind and reporting on their own behalf, and including all Federal, State, or Tribal royalty owner's interest. Exempt Royalty, Processing, and Transportation - Enter the value of the Federal, State, or Tribal Royalty exemptions, combined with the total allowable Transportation costs, and the total allowable Processing deduction. Taxable Value - Enter the remainder of Gross Sales Value minus reported Exempt Royalty, Transportation, and Processing. Total Tax Due - Equals taxable value times the applicable tax rate, per the Rate Code Table.
Form 3000 Instructions Page 2
Page Total - Enter the Sum of the Total Tax Due Column on this Form 2000. Amendments are replacement filings not net change filings A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code. For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting current payment. Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually, by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest. Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest. All forms must be signed and dated originals.
Severance Rate Code Table for Gas (as of 1/1/2000) Rate Severance Rate Code Mineral Type Description Tax Rate BAS Gas Group No Incentives (base rate) .060 WRK Gas Well Workover - Incremental .020 REC Gas Well Recompletion - Incremental .020 NEW Gas Well New Well .020 WLD Gas Well Wildcat .020 NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must complete and attach 3002, Severance Tax Schedule.
The mailing address for all Department of Revenue mineral forms is: Wyoming Department of Revenue Mineral Tax Division 122 West 25th Street Cheyenne, WY 82002-0110
10/18/2001
O - Original A - Amended
VALUES ONLY.
NOTE: Taxpayer’s name. Do not enter an For amended returns (Form Type ‘A’) report REPLACEMENT agent’s name here.
Contact Phone Number:
!"###!
3000
Authorized Signature
Title
Severance Tax Form 3000; page 1
Date
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.
PAGE TOTAL:
number. Total Tax Due must be reported to the cent.
NOTE: For amendments Total Tax Due is the replacement amount and not reflect previous tax applied Use Form 3000 to report gas and plant products including plant condensatewill (liquids your account. Be sure to account to separated at a main processing plant). for tax previously applied to your account prior to remitting the payment. Always report volumes and values except Total Tax Due rounded to the nearest whole
Name of the person, agent, or agency responsible for completing this report who can answer questions regarding this report.
requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Contact Person or Agent's telephone number including area code and extension. NOTE: A change in Rate Code
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
SEVERANCE TAX REPORT Enter ‘O’ for an original GASreport. Enter ‘A’ for an amended report
Taxpayer’s Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division.
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Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
Taxpayer Name:
PAGE TOTAL:
Operators enter mcf sold, after deducting mcf taken in-kind. Take In-Kind interest owners enter mcf taken in-kind.
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3000
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
Enter the proper Rate Code Identifier for the Reporting Group (see Rate Code Table). Form 3000 is used to enter the combined Rate Code total for a specific Reporting Group. Individual wells in a Reporting Group that qualify for well incentives must also be itemized on Form 3002.
Enter the five digit Reporting Group Number assigned by the Mineral Tax Division.
Month and year (mmyyyy). If you are an annual filer report production for the entire year as December (12yyyy).
O - Original A - Amended
DEPARTMENT OF REVENUE USE ONLY:
SEVERANCE TAX REPORT GAS
Authorized Signature
Title
Severance Tax Form 3000; page 2
Date
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.
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Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
revenue relating to the production for the
Enter the value of the Federal, State, or Tribal Royalty exemptions, combined with the total allowable transportation costs and the total allowable processing deduction.
PAGE TOTAL:
Enter the remainder of Gross Sales Value minus Exempt Royalty and Transportation.
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
!"###!
3000
Authorized Signature
Title
Severance Tax Form 3000; page 3
Date
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.
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7
behalf, and including all Federal, State, or 6 Tribal royalty owner's, not taking royalty inkind, interest.
5 taking in-kind and reporting on their own
3 reported period, including tax reimbursements and all other revenue 4 received or credited to all interest owners not
Taxpayer Name: Contact Phone Number:
SEVERANCE TAX REPORT GAS DEPARTMENT OF REVENUE USE ONLY:
Enter the gross sales value for the production
2 period. Gross Sales Value includes all
1
Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Authorized Signature
Title
Severance Tax Form 3000; page 4
Date
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.
PAGE TOTAL:
Rate Severance Rate Code Mineral Type Description Tax Rate BAS Gas Group No Incentives (base rate) .060 WRK Gas Well Workover - Incremental .020 REC Gas Well Recompletion - Incremental .020 NEW Gas Well New Well .020 WLD Gas Well Wildcat .020 NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must complete and attach 3002, Severance Tax Schedule.
Severance Rate Code Table for Gas (as of 1/1/2002)
!"###!
3000
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
SEVERANCE TAX REPORT GAS
Equals the taxable value times the applicable tax rate per the Rate Code Table.
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Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
Wyoming Department of Revenue Mineral Tax Division 122 West 25th Street Cheyenne, WY 82002-0110
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Authorized Signature
Title
Severance Tax Form 3000; page 5
Date
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.
All paper forms PAGE must beTOTAL: signed and dated originals.
The mailing address for all Department of Revenue mineral forms is:
!"###!
3000
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
SEVERANCE TAX REPORT GAS
Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually, by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest.
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Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
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O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
PAGE TOTAL:
Contact Phone Number:
Authorized Signature
Title
Date
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the current payment.
NOTE: A change in Rate Code requires BOTH an amended report for for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
!"###!
3000
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.
Contact Name:
Form Type:
Operator ID:
SEVERANCE TAX REPORT GAS
USE Form 3000 TO REPORT GAS AND PLANT PRODUCTS INCLUDING PLANT CONDENSATE (liquids separated at a processing plant). REPORT ALL VOLUMES AND VALUES (EXCEPT TAX FIELDS) ROUNDED TO THE NEAREST WHOLE NUMBER. TAX MUST BE REPORTED TO THE CENT. Operator ID – Enter the 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. Form Type -
Enter "O" for an Original Report. Enter "A" for an Amended Report.
Taxpayer Name – Enter Taxpayer's name. Do not enter a tax agent. Contact Name - Enter the name of the person who can answer questions about this form. Contact Phone Number - Enter the Contact person’s phone number. Production Period - Month and year (mmyyyy). If you qualify as an annual filer, report production for the entire year on one line as December (12yyyy). Reporting Group Number - Enter the five digits Reporting Group Number assigned by the Mineral Tax Division. Rate Code - Enter the proper rate code identifier for the Reporting Group (see Rate Code Table). Form 3000 is used to enter the combined Rate Code total for a specific Reporting Group. Individual wells in a Reporting Group that qualify for well incentives must also be itemized on Form 3002, Severance Tax Schedule Gas Well Incentive Reporting. Gross Sales Volume - Operators, enter gross MCF sold, after deducting gross MCF taken in-kind by interest owners who are reporting on their own behalf. Take in-kind interest owners enter gross MCF taken in-kind. Gross Sales Value - Enter the gross sales value for the production period. Gross Sales Value includes all revenue relating to the production for the reported period, including tax reimbursements and all other revenue received or credited to all interest owners not taking in-kind and reporting on their own behalf, and including all Federal, State, or Tribal royalty owner's interest. Exempt Royalty, Processing, and Transportation - Enter the value of the Federal, State, or Tribal Royalty exemptions, combined with the total allowable Transportation costs, and the total allowable Processing deduction. Taxable Value - Enter the remainder of Gross Sales Value minus reported Exempt Royalty, Transportation, and Processing. Total Tax Due - Equals taxable value times the applicable tax rate, per the Rate Code Table.
Form 3000 Instructions Page 2
Page Total - Enter the Sum of the Total Tax Due Column on this Form 2000. Amendments are replacement filings not net change filings A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code. For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting current payment. Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually, by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest. Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest. All forms must be signed and dated originals.
Severance Rate Code Table for Gas (as of 1/1/2000) Rate Severance Rate Code Mineral Type Description Tax Rate BAS Gas Group No Incentives (base rate) .060 WRK Gas Well Workover - Incremental .020 REC Gas Well Recompletion - Incremental .020 NEW Gas Well New Well .020 WLD Gas Well Wildcat .020 NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must complete and attach 3002, Severance Tax Schedule.
The mailing address for all Department of Revenue mineral forms is: Wyoming Department of Revenue Mineral Tax Division 122 West 25th Street Cheyenne, WY 82002-0110
10/18/2001
O - Original A - Amended
VALUES ONLY.
NOTE: Taxpayer’s name. Do not enter an For amended returns (Form Type ‘A’) report REPLACEMENT agent’s name here.
Contact Phone Number:
!"###!
3000
Authorized Signature
Title
Severance Tax Form 3000; page 1
Date
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.
PAGE TOTAL:
number. Total Tax Due must be reported to the cent.
NOTE: For amendments Total Tax Due is the replacement amount and not reflect previous tax applied Use Form 3000 to report gas and plant products including plant condensatewill (liquids your account. Be sure to account to separated at a main processing plant). for tax previously applied to your account prior to remitting the payment. Always report volumes and values except Total Tax Due rounded to the nearest whole
Name of the person, agent, or agency responsible for completing this report who can answer questions regarding this report.
requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Contact Person or Agent's telephone number including area code and extension. NOTE: A change in Rate Code
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
SEVERANCE TAX REPORT Enter ‘O’ for an original GASreport. Enter ‘A’ for an amended report
Taxpayer’s Operator ID as assigned by the Wyoming Oil and Gas Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division.
MTSII 10/8/01
12
11
10
9
8
7
6
5
4
3
2
1
Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
Taxpayer Name:
PAGE TOTAL:
Operators enter mcf sold, after deducting mcf taken in-kind. Take In-Kind interest owners enter mcf taken in-kind.
!"###!
3000
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
Enter the proper Rate Code Identifier for the Reporting Group (see Rate Code Table). Form 3000 is used to enter the combined Rate Code total for a specific Reporting Group. Individual wells in a Reporting Group that qualify for well incentives must also be itemized on Form 3002.
Enter the five digit Reporting Group Number assigned by the Mineral Tax Division.
Month and year (mmyyyy). If you are an annual filer report production for the entire year as December (12yyyy).
O - Original A - Amended
DEPARTMENT OF REVENUE USE ONLY:
SEVERANCE TAX REPORT GAS
Authorized Signature
Title
Severance Tax Form 3000; page 2
Date
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.
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11
10
9
8
7
6
5
4
3
2
1
Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
revenue relating to the production for the
Enter the value of the Federal, State, or Tribal Royalty exemptions, combined with the total allowable transportation costs and the total allowable processing deduction.
PAGE TOTAL:
Enter the remainder of Gross Sales Value minus Exempt Royalty and Transportation.
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
!"###!
3000
Authorized Signature
Title
Severance Tax Form 3000; page 3
Date
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.
MTSII 10/8/01
12
11
10
9
8
7
behalf, and including all Federal, State, or 6 Tribal royalty owner's, not taking royalty inkind, interest.
5 taking in-kind and reporting on their own
3 reported period, including tax reimbursements and all other revenue 4 received or credited to all interest owners not
Taxpayer Name: Contact Phone Number:
SEVERANCE TAX REPORT GAS DEPARTMENT OF REVENUE USE ONLY:
Enter the gross sales value for the production
2 period. Gross Sales Value includes all
1
Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Authorized Signature
Title
Severance Tax Form 3000; page 4
Date
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.
PAGE TOTAL:
Rate Severance Rate Code Mineral Type Description Tax Rate BAS Gas Group No Incentives (base rate) .060 WRK Gas Well Workover - Incremental .020 REC Gas Well Recompletion - Incremental .020 NEW Gas Well New Well .020 WLD Gas Well Wildcat .020 NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must complete and attach 3002, Severance Tax Schedule.
Severance Rate Code Table for Gas (as of 1/1/2002)
!"###!
3000
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
SEVERANCE TAX REPORT GAS
Equals the taxable value times the applicable tax rate per the Rate Code Table.
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10
9
8
7
6
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4
3
2
1
Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
Wyoming Department of Revenue Mineral Tax Division 122 West 25th Street Cheyenne, WY 82002-0110
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the payment.
NOTE: A change in Rate Code requires BOTH an amended report for the originally reported rate code and an original report for the new rate code.
Authorized Signature
Title
Severance Tax Form 3000; page 5
Date
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.
All paper forms PAGE must beTOTAL: signed and dated originals.
The mailing address for all Department of Revenue mineral forms is:
!"###!
3000
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
Contact Phone Number:
SEVERANCE TAX REPORT GAS
Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month following the month of production. If a taxpayer’s total liability for severance tax was less than $30,000 for the preceding calendar year, the taxpayer can report annually, by February 25 of the year following the production year. All delinquent severance taxes are subject to penalty and interest.
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7
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3
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Contact Name:
Form Type:
Operator ID:
Severance Tax Form Instructions
MTSII 10/8/01
12
11
10
9
8
7
6
5
4
3
2
1
O - Original A - Amended
Taxpayer Name:
DEPARTMENT OF REVENUE USE ONLY:
PAGE TOTAL:
Contact Phone Number:
Authorized Signature
Title
Date
NOTE: For amendments Total Tax Due is the replacement amount and will not reflect previous tax applied to your account. Be sure to account for tax previously applied to your account prior to remitting the current payment.
NOTE: A change in Rate Code requires BOTH an amended report for for the originally reported rate code and an original report for the new rate code.
NOTE: For amended returns (Form Type ‘A’) report REPLACEMENT VALUES ONLY.
!"###!
3000
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.
Contact Name:
Form Type:
Operator ID:
SEVERANCE TAX REPORT GAS
