Alternative Tax Credit For Oil And Gas Exploration Under As 43.55.025
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310:09 06 13
Alaska
310
Alternative Tax Credit for Oil and Gas
Exploration under AS 43.55.025
Summary
Federal EIN
Date of Claim
Name of Single Explorer or Designated Joint Applicant
Mailing Address
City
State
Zip Code
Contact Person for Examination of Records
Title
Phone Number
Fax Number
Email Address of Contact Person
Business Type
Corporation
Partnership
Sole Proprietor
LLC
Other ______________
Exploration Project Description
Name of exploration project
Location of exploration project (select from drop down)
Blank
Type of exploration project: exploratory well, seismic project, or other geophysical exploration
Type of interest in the project held by the applicant: operator, partner, etc
Exploration Credit
(select from drop down)
80%, 90% or 100% credit under AS 43.55.025(l)
Supporting Information
Check if Schedule D is attached as required by AS 43.55.025(f)(2)
Check if Schedule E is attached for a consortium of explorers
Check if copy of Well Completion Report or Application for Sundry Approvals is attached (AOGCC form)
Check if copy of survey or plat map showing location of well or exploration activities is attached
Check if well or project was included in a Plan of Development or exploration as of May 13, 2003
I declare under penalty of perjury that this application and each attachment has been examined by me and to the
best of my knowledge and belief is true, correct and complete.
Signature
Date
Print Name
Print Title
This form is available online at
Submit completed applications via the Tax Division Online Tax
Information System (OTIS) at
310
Mail to: Alaska Department of Revenue, 550 W 7th Ave STE 500, Anchorage AK 99501-3555
0405-310 Rev 09/06/13- page 1
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