Form 2000 - Severance Tax Report Oil Page 4
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1
2
3
4
5
6O - Original
Form Type:
Taxpayer Name:
A - Amended
Contact Name:
Contact Phone Number:
PRODUCTION
REPORTING
RATE
GROSS SALES
GROSS SALES
EXEMPT
TAXABLE
TOTAL TAX DUE
PERIOD
GROUP
CODE
VOLUME
VALUE
ROYALTY AND
VALUE
(mmyyyy)
NUMBER
TRANSPORTATION
NOTE: For amended returns
1
Equals the taxable value times the applicable tax rate per the Rate Code Table.
(Form Type ‘A’) report
VALUES ONLY.
2
3
Severance Rate Code Table for Oil
NOTE: A change in Rate Code
4
Rate
Rate
Severance
requires BOTH an amended
Code
Mineral
Type
Description
Tax Rate
for the originally reported rate
5
BAS
Oil
Group
No Incentives (base rate)
.060
code and an original report for the
S10
Oil
Group
Stripper up to 10 barrels per day
.040
new rate code.
6
S15
Oil
Group
Stripper between 11 bbls and 15 bbls per day
.040
7
LCD
Oil
Group
Lease Condensate
.060
REN
Oil
Well
Renewed Production
.015
NOTE: For amendments Total
8
NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must
Tax Due is the replacement
complete and attach 2002, Severance Tax Schedule.
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
current payment.
11
12
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
State of Wyoming
2000
SEVERANCE TAX REPORT
Department of Revenue
*2000*
122 West 25th Street
OIL
Cheyenne WY 82002-0110
DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
Form Type:
Taxpayer Name:
A - Amended
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