Form 10-163 - Texas Report Of Natural Gas Tax - 2011
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210-163
DDDD
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(Rev.3-11/4)
b.
49100
a.
Page ______ of ______
See instructions on back.
Texas Report of Natural Gas Tax
c. Taxpayer number
d. Filing period
-- Producer Lease Detail Supplement --
f.
e. Taxpayer name
HP
1. Lease name (as recorded with the Railroad Commission)
1. Lease name (as recorded with the Railroad Commission)
2. County of production
2. County of production
3. Commodity
3. Commodity
(Use the alpha codes listed in the instructions.)
(Use the alpha codes listed in the instructions.)
4. Commodity code
4. Commodity code
(Numeric)
(Numeric)
OIL
GAS
OIL
GAS
5. Lease type
5. Lease type
1
2
1
2
6. County code
6. County code
Check
Check
digit
digit
7. Lease number
7. Lease number
YES
NO
YES
NO
1
2
1
2
8. Is Item 7 a drilling permit number?
8. Is Item 7 a drilling permit number?
9. Exemption type
9. Exemption type
10. API number
10. API number
YES
NO
YES
NO
1
2
1
2
11. Is this an off-lease sale?.
11. Is this an off-lease sale?.
12. Purchaser's name
12. Purchaser's name
13. Purchaser taxpayer
13. Purchaser taxpayer
number
number
14. Total lease
14. Total lease
volume
volume
YES
NO
YES
NO
15. Is tax reimbursement included in
15. Is tax reimbursement included in
1
2
1
2
calculating the value on this lease?
calculating the value on this lease?
16. Your
16. Your
volume
volume
$
$
17. Value of
17. Value of
your volume
your volume
YES
NO
YES
NO
1
2
1
2
18. Are you liable for the tax?
18. Are you liable for the tax?
If "NO" in Item 18, do not complete Items 19 thru 24.
If "NO" in Item 18, do not complete Items 19 thru 24.
19. Governmental
19. Governmental
royalty volume
royalty volume
$
$
20. Governmental
20. Governmental
royalty value
royalty value
$
$
21. Marketing
21. Marketing
cost
cost
$
$
22. Net taxable
22. Net taxable
value
value
Items 23 and 24 for Exemption Type 05 leases only.
Items 23 and 24 for Exemption Type 05 leases only.
23. Reduced tax rate for Type 05
23. Reduced tax rate for Type 05
$
$
24. Tax due on
24. Tax due on
Type 05
Type 05
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