Form 3000 - Severance Tax Report Gas - Wyoming Department Of Revenue Page 6
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8Severance Tax Form Instructions
6WDWH RI :\RPLQJ
3000
SEVERANCE TAX REPORT
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
GAS
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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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5$7(
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727$/ 7$; '8(
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180%(5
75$163257$7,21
NOTE: For amended returns (Form
1
Equals the taxable value times the applicable tax rate per the Rate Code Table.
Type ‘A’) report REPLACEMENT
VALUES ONLY.
2
Severance Rate Code Table for Gas
(as of 1/1/2002)
3
Rate
Severance
NOTE: A change in Rate Code
4
Rate Code
Mineral
Type
Description
Tax Rate
requires BOTH an amended report
BAS
Gas
Group
No Incentives (base rate)
.060
for the originally reported rate code
5
WRK
Gas
Well
Workover - Incremental
.020
and an original report for the
REC
Gas
Well
Recompletion - Incremental
.020
new rate code.
6
NEW
Gas
Well
New Well
.020
7
WLD
Gas
Well
Wildcat
.020
NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must
NOTE: For amendments Total Tax
8
complete and attach 3002, Severance Tax Schedule.
Due is the replacement amount and
will not reflect previous tax applied
9
to your account. Be sure to account
for tax previously applied to your
10
account prior to remitting the
payment.
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MTSII 10/8/01
PAGE TOTAL:
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
Severance Tax Form 3000; page 4
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