State Form 9931 - Property Schedule For Gas And Oil Well Assessment
Download a blank fillable State Form 9931 - Property Schedule For Gas And Oil Well Assessment in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete State Form 9931 - Property Schedule For Gas And Oil Well Assessment with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Reset Form
PROPERTY SCHEDULE FOR GAS AND OIL WELL ASSESSMENT
March 1, 20 ______
State Form 9931 (R5 / 1-09)
FORM
Prescribed by Department of Local Government Finance
G & O-1
PRIVACY NOTICE
The records in this series
INSTRUCTIONS: 1. File separate schedule for each gas and oil lease.
are confidential according to
IC 6-1.1-35-9.
2. The form is to be filed with the Assessor not later than May 15 of each year.
3. Gas and oil interests are assessable per IC 6-1.1-4-12.4 and IC 6-1.1-4-12.6.
SECTION 1
TAXPAYER INFORMATION
Name
Telephone number
(
)
Address (number and street, city, state, and ZIP code)
(Check one)
Contact person
Title of contact person
Owner
Operator
SECTION 2
LEASE INFORMATION
Location
County
DLGF taxing district number
Township
Legal description
Range
Acres
Lease
Section
Township
Check if the well is an oil well using secondary recovery method. Also check if the well stimulates oil production by means of injection of water, steam,
hydrocarbons, or chemicals, or by in situ combustion. (IC 6-1.1-4-12.6)
SECTION 3
FACTORS FOR BASIS OF ASSESSMENT
A.
Price per unit of gas or oil on assessment date (per DLGF)
Per MCF or barrels
3A.
B.
Average daily production of gas or oil
3B.
C.
Annual production value (multiply 3A. by 3B. by 365)
3C.
0.00
Enter 0.5 if secondary recovery method in use
D.
3D.
Enter 1.0 if initial recovery method
E.
Interest in gas or oil rights (multiply 3C. by 3D.)
3E.
0.00
F.
Appurtenances - enter number of producing wells
3F.
G.
Enter value of single well appurtenance (per DLGF)
3G.
H.
Total value of appurtenances (multiply 3F. by 3G.)
3H.
0.00
I.
Total basis of working interest assessment (Sum 3E. and 3H. and enter here and in 5A.)
3I.
0.00
SECTION 4
COMPUTATION OF ROYALTY INTEREST ASSESSMENT
A.
Interest in gas or oil rights (from 3E.)
4A.
0.00
B.
Basis for royalty assessment (multiply 4A. by 1.50)
4B.
0.00
C.
Enter royalty interest factor (for example, 0.1250 for 1/8 interest)
4C.
D.
Total royalty interest assessment subject to allocation on page 2 (multiply 4B. by 4C.)
4D.
0.00
SECTION 5
COMPUTATION OF WORKING INTEREST ASSESSMENT
A.
Total basis of working interest assessment (from line 3I.)
5A.
0.00
B.
Enter total royalty interest assessment (from 4D.)
5B.
0.00
C.
Working interest factor
Working interest assessment (subtract 5A. minus 5B.)
5C.
Page 1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Rpie-203-02 - Real Property Income And Expense Schedule For Cooperative And Condominium Property
Financial
Form It-254 - Claim For Residential Fuel Oil Storage Tank Credit - New York State Department Of Taxation And Finance - 2003
Financial
Related Categories
Parent category: Legal