Form 10-157 - Purchaser Report Of Natural Gas Tax
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410-157
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(Rev.6-12/3)
b.
37180
a.
under Chapters 552 and 559, Government Code, to
You have certain rights
review, request and correct information we have on file about you. Contact us
at the address or phone number listed on this form.
Texas Comptroller of Public Accounts
PURCHASER REPORT OF NATURAL GAS TAX
Page 1 of ______
c. Taxpayer number
d. Due date
e. Filing period
f.
FM
h.
i.
Taxpayer name and mailing address
g.
Blacken this box if your address has changed.
1
Show changes by the preprinted information.
FINAL REPORT - Blacken this box if you are
2
no longer in business
and enter the last
business date
j.
If you have nothing to report for ALL leases for this filing period, blacken
this box, sign and date this report, and return it to the Comptroller's office.
B l a
A REPORT MUST BE FILED EVEN IF NO TAX IS DUE
REPORT TOTALS AND TAX COMPUTATION (See instructions)
1. Total net taxable value of condensate
$
(Enter dollars and cents.)
1.
2. Tax due on condensate
$
(Multiply Item 1 by
. Enter dollars and cents.)
2.
3. Total net taxable value of gas (Excluding leases with exemption Type 05 high cost gas)
$
(Enter dollars and cents.)
3.
4. Tax due on gas (Excluding leases with exemption Type 05 high cost gas)
$
4.
(Multiply Item 3 by
. Enter dollars and cents.)
5. Taxable regulatory fee volume
5.
(See instructions. Round volume to whole numbers.)
6. Regulatory fee due
$
(Multiply Item 5 by
. Enter dollars and cents.)
6.
7. Tax due on leases with exemption Type 05 high cost gas
$
(Total of Item 22 from attached Lease Detail Supplements, Form 10-171. Enter dollars and cents.)
7.
8. Total tax and fee due
$
(Add Items 2, 4, 6 and 7. Enter dollars and cents.)
8.
* * * DO NOT DETACH * * *
10-157
(Rev.6-12/3)
9. Credits
$
9.
(NOT valid without attached Credit Transfer Form for Natural Gas Tax, Form 10-147)
$
10. Net amount due
10.
(Item 8 minus Item 9)
$
11. Penalty & Interest
11.
(If report is filed or tax paid after the due date, see instructions.)
12. TOTAL AMOUNT DUE AND PAYABLE
$
(Item 10 plus Item 11)
12.
Taxpayer name
l.
T Code
Taxpayer number
Period
Make the amount in Item 12 payable to: State Comptroller
37020
Mail to:
I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief.
Comptroller of Public Accounts
Print name
Business phone (Area code and number)
P.O. Box 149358
Austin, TX 78714-9358
Taxpayer or duly authorized agent
Date
m.
777
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