Form Ogp-D - 2015 Annual Report Of Non-Resident Remittees Holding An Agreement To Pay Tax On Oil And Gas Proceeds
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1
2New Mexico Taxation and Revenue Department
*154080200*
2015 Annual Report of Non-Resident
Remittees Holding an Agreement to Pay
Tax on Oil and Gas Proceeds
1
Page ______ of _______
Check if amended
Remitter’s name
Remitter’s FEIN or SSN
Line 1. Total New Mexico gross oil and
gas proceeds distributed by the remitter.
Check one:
FEIN
SSN
FOR DEPARTMENT
Remitter’s Address - (Number and street)
City
State
Postal/ZIP code
USE ONLY
If foreign address, enter country
Foreign province and/or state
Column 2
Column 3
Column 4
Remittee’s name,
street address,
Remittee’s SSN or FEIN
Remittee’s oil and
Tax withheld and
gas proceeds
paid by the remitter
city, state, and ZIP code
Mark one:
FEIN
Mark if outside the U.S.
SSN
Mark one:
FEIN
Mark if outside the U.S.
SSN
Mark one:
FEIN
Mark if outside the U.S.
SSN
Mark one:
FEIN
Mark if outside the U.S.
SSN
Mark one:
FEIN
Mark if outside the U.S.
SSN
Mark one:
FEIN
Mark if outside the U.S.
SSN
File this report online through Taxpayer Access Point (TAP)
2.
Line 2. Total of this page.
at https://tap.state.nm.us. Under FOR BUSINESSES, click
Make a Payment and in Account Type, select OGP Remitter.
Line 3. Total from all pages.
3.
If you cannot electronically file, see the instructions. For help
completing this report, call (505) 827-0825.
I declare I have examined this report and to the best of my knowledge and belief it is true, correct, and complete.
Authorized signature ___________________________________________________ Date ____________________________________________
Phone number ___________________________________ Email address _________________________________________________________
OGP-D
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