Form 201 Fp - Forest Products Harvest Tax Return Sample (2004) - Oregon Department Of Revenue Page 15

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DEPARTMENT USE ONLY
Form
FOREST PRODUCTS HARVEST TAX RETURN
Date Received
201A
•
2004
10065544
Business Identifi cation Number
SAMPLE TAXPAYER
200 ANY STREET
EXAMPLE CITY OR 97219
1
2
3
4
5
6
7
8
Landowner
Town ship
Range
Sec-
•
•
Forestry Notifi cation Number (permit)
Operator
Sale Name/Contract Number
County
N or S
E or W
tion
Volume (MBF)
40
2004-711-75678-01
SUGARLOAF MTN
FOREST PRODUCTS
17
385
2W
02
8
40
Volume Subtotal
(Add all entries in column 8—this page)
150-502-201-1 (Rev. 7-04)
15
150-441-409 (Rev. 2-05)

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