Form Mts2 - Severance Tax Report Gas
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1SEVERANCE TAX REPORT
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DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
Form Type:
Taxpayer Name:
A - Amended
Contact Name:
Contact Phone Number:
352'8&7,21
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PAGE TOTAL:
MTS2 12/16/99
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.
Authorized Signature
Title
Date
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