Form Dor Form 82063 - Property Tax Form - Oil, Gas And Geothermal Interests

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CONFIDENTIAL
PROPERTY TAX FORM
OIL, GAS & GEOTHERMAL INTERESTS
TAX YEAR 2014
DUE: April 1, 2013
TO
STATE OF ARIZONA, DEPARTMENT OF REVENUE
Property Tax Division
Centrally Valued Property Unit
th
1600 W. Monroe, 8
Floor
Phoenix, Arizona 85007
Telephone: (602) 716-6071
Fax: (602) 542-4425
Email address: vfagan@azdor.gov
Year Ending December 31, 2012
OFFICIAL MAILING ADDRESS
(Please make any corrections to name and/or address)
Refer Correspondence to:
Title:
Telephone:
Email Address:
Company Name:
Street Address:
City:
State:
Zip:
I N S T R U C T I O N S
This report form is required to be filed in order to provide the information necessary for the
determination of the full cash value of oil, gas, and geothermal interests in Arizona valued
under provisions of ARS §§ 42-14101 through 42-14106.
Return complete report, including this page. DO NOT DETACH ANY PAGES. The report,
complete with all attached schedules and supplementary information, must be returned to
the above address by April 1, 2013. The verification page must be signed and notarized
for the report to be considered complete.
REFUSAL OR FAILURE TO FILE:
FAILURE TO FILE a completed report ON OR BEFORE April 1, or the extended due date
if an extension is granted, will result in a valuation of one hundred five percent of the prior
year's full cash value or a value based upon other information available to the Department.
In addition, a penalty will be assessed in the amount of the lesser of one-half of one
percent of the value estimated by the Department or one hundred dollars per day for each
day the taxpayer fails to file the report. The number of days late will be calculated from
the original due date, April 1, 2013. (ARS § 42-14052)
DOR Form 82063 (Revised 11-12)
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