Form Rp-7019 - Oil And Gas Economic Profile Form For The Year Ending December 31
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1New York State Department of Taxation and Finance
RP-7019
Office of Real Property Tax Services
(4/14)
Oil and Gas Economic Profile Form
For the Year Ending December 31, 20
Producers of more than 1,000 barrels of oil or 200,000 MCFs of gas are required by law to submit this form.
Fill out all information accurately and completely. Attach additional information if necessary.
Section 1: Producer information
Producer name:
Formation*:
Address:
Average well age:
Representative:
Average well depth:
Phone number:
County:
Email address:
Town/City:
Section 2: Well type and royalty information
Well type (mark a box):
Production type (for oil wells) (mark a box):
Oil
Gas
Both**
Stripper Wells
Enhanced recovery wells
Both
Gas well royalties:
Oil well royalties:
Land owner royalties:
$
%
Land owner royalties:
$
%
Overriding royalties:
$
%
Overriding royalties:
$
%
Total royalties:
$
%
Total royalties:
$
%
Section 3: Production and income information
Gas wells:
Oil wells:
Total number of wells reported on this form:
Total number of wells reported on this form:
Total production of wells (MCFs):
Total production of wells (barrels):
Total gross income:
$
Total gross income:
$
Section 4: Expense information
Gas wells:
Oil wells:
Total operating expenses (IOEs):
$
Total operating expenses (IOEs):
$
Depreciation:
$
Depreciation:
$
Depletion:
$
Depletion:
$
Dry hole costs:
$
Dry hole costs:
$
Reserve for abandonment:
$
Reserve for abandonment:
$
* If drilling in Medina, please indicate which Medina region. For a breakdown, go to ,
or call the number below.
** If your wells are producing both gas and oil, separate the expenses, income and royalties.
Certification
I
,
, of
Name
Title
Company name
certify that the above information for the calendar year of 20
is true to the best of my knowledge and belief.
Signature
Date
Mail to:
NYS TAX DEPARTMENT
ORPTS OIL AND GAS UNIT
W A HARRIMAN CAMPUS
ALBANY NY 12227
If you have any questions regarding this form or the program, call (518) 530-4049.
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