Form Rpd-41283 - Annual Summary Of Oil And Gas Proceeds Withholding Tax

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State of New Mexico - Taxation and Revenue Department
RPD-41283
Rev. 12/20/2011
ANNUAL SUMMARY OF OIL AND GAS PROCEEDS WITHHOLDING TAX
Remitters (payors) of oil and gas rents and royalties from property located in New Mexico who are
Who Must Complete This Form:
required to file federal Form 1099-MISC, and remitters of oil and gas proceeds from oil and gas production from wells located in New
Mexico who have withheld tax from payment(s) according to the Oil and Gas Proceeds and Pass-Through Entity Withholding Tax Act (7-
3A-1 NMSA 1978) must complete Form RPD-41283, Annual Summary of Oil and Gas Proceeds Withholding Tax, and retain the document
in their files. The annual summary reconciles the total oil and gas proceeds withholding tax withheld and reported to the Department on
Form RPD-41284, Quarterly Oil and Gas Proceeds Withholding Tax Return, and the amounts withheld from the remittees. Form RPD-
41283 should be completed by the last day of February of the year following the calendar year in which the payments were withheld.
For questions, contact (505) 827-0825.
PART I. Complete the following information about your company and the reporting year. (e.g. 2011)
Taxable year
Name and address of remitter of oil and gas proceeds
Federal employer identification number
or social security number
Name of person to contact
New Mexico CRS identification number
Telephone number
E-mail address
PART II. Schedule of New Mexico income tax withheld and reported on Form RPD-41284. Enter the New Mexico income
tax withheld and reported to the Department on Form RPD-41284, Quarterly Oil and Gas Proceeds Withholding Tax Return,
for each quarter during the reporting year. The reporting month is the month in which the taxes were withheld and not the
month the tax was due. Enter the sum of the tax withheld.
QUARTERLY REPORT PERIOD
AMOUNT
1. January through March
2. April through June
3. July through September
4. October through December
TOTAL
PART III. Complete lines 1 through 4 below. Reconcile the New Mexico income tax withheld and reported on Form RPD-
41284, to the New Mexico income tax withheld and reported on federal Form 1099-MISC, or RPD-41285, Annual Statement
of Withholding of Oil and Gas Proceeds.
1.
Enter the number of annual statements of withholding submitted to remittees. (Include the total number of
statements issued regardless of how they were submitted to the Department) ....................................................
2.
Enter the total New Mexico income tax withheld for the taxable year as shown on federal Forms
$
1099-MISC ............................................................................................................................................................
$
3.
Enter the total New Mexico income tax withheld and reported on Form RPD-41284 during the taxable year ......
$
4.
Enter the difference (Subtract the sum of lines 2 and 3, from the total reported in PART II.) ................................
PART IV. Sign and date the report.
I declare that I have examined this return and accompanying documents, and to the best of my knowledge and belief, they are true,
correct, and complete.
Signature:
Title:
Date:

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