Form O And G Offshore-3 - Oil And Gas Offshore Producer'S Tax Return Schedule

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O&G Offshore-3
LABAMA
EPARTMENT OF
EVENUE
Rev. 4/09
Reset Complete Form
S
, U
& B
T
D
ALES
SE
USINESS
AX
IVISION
______________________________
Production Month / Year
Oil and Gas Offshore Producer’s Tax Return Schedule
Wells producing from depths greater than 8,000 feet
Production Code
05 — Propane
Check the Appropriate Box for the County / Municipality of Severance
01 — Crude Oil
06 — Ethane
Use Separate Schedule For Each County / Municipality and Tax Rate
TAXPAYER NAME
02 — Condensate
07 — Natural Gasoline
Baldwin County
Mobile County
Mobile / Dauphin Island
03 — Residue / Methane Gas @ 14.65 PSI
08 — Plant Fuel / Lease Use – Oil
04 — Butane
09 — Plant Fuel / Lease Use – Gas
FEIN
Reset all but Well Unit/Permit
PURCHASERʼS LIABILITY
PRODUCERʼS LIABILITY
PERMIT
PRODUCT
100%
EXEMPT INTEREST
PRODUCERʼS
TIK
TIK
WELL / UNIT NAME
NUMBER
CODE
PRODUCTION
DEDUCTIONS
TAXABLE VALUE
VOLUME
PRODUCER
VOLUME
GROSS PROCEEDS
VOLUME
GROSS PROCEEDS
PAGE TOTALS
COUNTY TOTALS
REPORT TOTALS
1.66% Production Tax . . . . . . .
3.65% Privilege Tax . . . . . . . . .
TOTAL TAX REMITTED . . . . $
ATTACH TO: FORM O&G OFFSHORE-1

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