Form Mts2 - Annual Gross Products Take In-Kind Balance Sheet For Oil December - 1999
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1State of Wyoming
ANNUAL GROSS PRODUCTS
Department of Revenue
TAKE IN-KIND
122 West 25th Street
"
Cheyenne, WY 82002-0110
BALANCE SHEET FOR OIL
__ __ __ __
Production Year:
TAXPAYER INFORMATION
PRODUCING ASSET
Revenue Use Only
Reporting Group Number
Operator ID
Taxpayer
Reporting Group Name
B. Take In-Kind Interest Owner Volume Information
TIK Interest Owner Name
TIK Operator ID
Volume Taken
Page Total
(Enter here and on 4101, Section D, Line 5d)
MTS2
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.
12/16/99
Authorized Signature
Title
Date
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