Annual Gross Products Mtd Attachment For Gas - Wyoming Department Of Revenue

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ANNUAL GROSS PRODUCTS MTD
State of Wyoming
ATTACHMENT FOR GAS
Department of Revenue
122 West 25th Street
" !
Cheyenne, WY 82002-0110
__ __ __ __
Production Year:
TAXPAYER INFORMATION
PRODUCING ASSET
Reporting Group Number
Revenue Use Only
Operator ID
Taxpayer
Reporting Group Name
O = Original
O = Operator
A.
Form Type:
B.
Taxpayer Type:
A = Amended
T = Take In-Kind Interest Owner
C.
Processing Plant Name
D.
Plant Operator
E. PLANT PRODUCTS
Line
Product Type
Volume
Value
ID
1.
RESIDUE GAS
2.
NATURAL GAS LIQUIDS
3.
PLANT CONDENSATE
4.
SULFUR
5.
NON-HYDROCARBON GAS
6.
OTHER - Explain:
7.
OTHER - Explain:
8.
OTHER - Explain:
9.
OTHER - Explain:
10.
OTHER - Explain:
11.
OTHER - Explain:
12.
PLANT RE-INJECTION
N/A
13.
PLANT FLARED
N/A
14.
PLANT SHRINKAGE
N/A
GROSS VALUE OF PLANT PRODUCTS
(Enter on 4201, Section D, Line 7)
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.
MTSII
12/16/99
Authorized Signature
Title
Date

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