RECLAIMER'S MONTHLY TAX REPORT
OKLAHOMA TAX COMMISSION
323-R-96
AUDIT DIVISION
A.
2501 N. Lincoln Blvd.
Oklahoma City, Oklahoma 73194-0008
Check/Tracer Number
1. F.E.I. or S.S.N.
2. Company
3. Reporting Parties Name and Address
4. License
5. Date (Mo./Yr.)
Product
6. A. Page ____ of ____
Reporting
Numbers
Code
B. Type of
Number
3
Report____
B. OTC ASSIGNED
C. OIL RECLAIMED
D. DEDUCT
E. EXEMPT NON-TAXABLE
F. TAXABLE
G. AMOUNT OF TAX DUE
1.
2. Plant/Well
3. Merge
County
Number
1. Volume
2. Gross Value
1. Barrels
2. Value
1. Barrels
2. Value
1. G.P. Tax Due
2. P.E. Tax Due
3. Total Tax Due
Number
H. Page Totals
I. Report Totals
J. Penalty for Late Payment (10% of
Tax)
K. Interest for Late Payment (1 1/4% per Month of
Tax)
L. Total Remitted With This Report