State of Wyoming
ANNUAL GROSS PRODUCTS
8452
Department of Revenue
ATTACHMENT FOR BENTONITE
*8452*
122 West 25th Street
SCHEDULE A
Cheyenne, WY 82002-0110
Production Year:
__ __ __ __
TAXPAYER INFORMATION
MINE GROUP INFORMATION
Operator ID
Mine Group Number
Revenue Use Only
Taxpayer
Mine Group Name
A separate form 8451 must be filed with each form 8401
SALES INFORMATION
TONS
VALUE
25. Bulk Taconite Sales
26. Bagged Taconite Sales
27. Bulk Oil Well Sales
28. Bagged Oil Well Sales
29. Bulk Foundry Sales
30. Bagged Foundry Sales
31. Total Sales
COMPUTATION OF ADD-ON FACTOR
32. Direct Mining Costs (Line 14 MINING)
33. Direct in-mine transportation costs (line 19)
34. Total Direct Mining Cost (line 32 + line 33)
35. Current Year Total Direct Mining Cost per ton (line 34 / line 21 TONS)
36. Prior Year Total Direct Mining Cost per ton
37. Difference (line 35 - line 36)
38. Percentage change in Total Direct Mining Cost per Ton (line 37 / line 36)
39. Current Year Sales Value per Ton of Taconite, Oil Well, and Foundry Products
40. Prior Year Sales Value per Ton of Taconite, Oil Well, and Foundry Products
41. Difference (line 39 - line 40)
42. Percentage Change in Sales Value per Ton (line 41 / line 40)
43. Difference in Percentage Changes (line 42 - line 38)
44. Prior Year Add-on Factor
45. Difference in Percentage Changes x Prior Year Add-on Factor (line 43 x line 44)
46. Current Year Add-on Factor (line 44 + line 45)
ROYALTY INFORMATION
TONS
VALUE
47. Federal Royalty
48. State Royalty
49. Tribal Royalty
50. Private Royalty
51. Total Royalty
MTS2
2/05/10