Form T12 - Oil Report Amendment Instructions Page 2

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Value of Exempt
Other Party
Sequence
Barrels of Oil
Value of Oil
Taxable Value
Total Production
Production Tax
Production Tax
Production Tax
Total Extraction
Extraction Tax
Extraction Tax
Extraction Tax
Well
Pool
Posting
Oil
Additional
Transportation
Other
Condensate
API Number
Government
Federal I.D.
Number
Purchased/Sold
Purchased/Sold
of Oil
Tax Due
Previously Paid
Paid By Others
Paid with Report
Tax Due
Previously Paid
Paid By Others
Paid with Report
Code
Code
Code
Gravity
Value
Deduction
Deductions
(Y or N)
(i.e. 01201234)
Royalties
Number
ORIGINAL ENTRY: (Example 1)
Tax Due
01201234
1
100.00
2000.00
0.00
2000.00
100.00
0.00
0.00
100.00
80.00
0.00
0.00
80.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
No Tax Due
01201234
1
100.00
2000.00
0.00
2000.00
100.00
0.00
100.00
0.00
80.00
0.00
80.00
0.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
WELL CODE CHANGE: (Example 2)
Tax Due
01201234
1
100.00
2000.00
0.00
2000.00
100.00
100.00
0.00
0.00
130.00
80.00
0.00
50.00 WW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
Credit/Refund
01201234
1
100.00
2000.00
0.00
2000.00
100.00
100.00
0.00
0.00
0.00
80.00
0.00
(80.00) S1
40 NX01
40.0
0.00
0.00
0.00
N
123456789
No Tax Due
01201234
1
100.00
2000.00
0.00
2000.00
100.00
0.00
100.00
0.00
130.00
0.00
130.00
0.00 WW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
VOLUME/VALUE CHANGE: (Example 3)
Tax Due
01201234
1
150.00
3000.00
0.00
3000.00
150.00
100.00
0.00
50.00
120.00
80.00
0.00
40.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
Credit/Refund
01201234
1
50.00
1000.00
0.00
1000.00
50.00
100.00
0.00
(50.00)
40.00
80.00
0.00
(40.00) NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
No Tax Due
01201234
1
150.00
3000.00
0.00
3000.00
150.00
0.00
150.00
0.00
120.00
0.00
120.00
0.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
CHANGE FOR INVENTORY SPLIT: (Example 4)
Credit/Refund
01201234
1
50.00
1000.00
0.00
1000.00
50.00
100.00
0.00
(50.00)
40.00
80.00
0.00
(40.00) NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
01201234
2
50.00
1000.00
0.00
1000.00
50.00
0.00
0.00
50.00
0.00
0.00
0.00
0.00 S1
40 NX01
40.0
0.00
0.00
0.00
N
123456789
Coversheet Totals
$0.00
($40.00)
No Tax Due
01201234
1
50.00
1000.00
0.00
1000.00
50.00
0.00
50.00
0.00
40.00
0.00
40.00
0.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
01201234
2
50.00
1000.00
0.00
1000.00
50.00
0.00
50.00
0.00
0.00
0.00
0.00
0.00 S1
40 NX01
40.0
0.00
0.00
0.00
N
123456789
API NUMBER CHANGE: (Example 5)
01201234
1
0.00
0.00
0.00
0.00
0.00
100.00
0.00
(100.00)
0.00
80.00
0.00
(80.00) NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
01204321
1
100.00
2000.00
0.00
2000.00
100.00
0.00
0.00
100.00
80.00
0.00
0.00
80.00 NW
40 NX01
40.0
0.00
0.00
0.00
N
123456789
Coversheet Totals
$0.00
$0.00

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