Severance Tax Schedule (Severance Tax Form 3002) - Gas Well Incentive Reporting Page 2
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4Severance Tax Form Instructions
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3002
SEVERANCE TAX SCHEDULE
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Gas Well Incentive Reporting
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DEPT. OF REVENUE USE ONLY:
Operator ID:
Taxpayer Name:
API NUMBER
352'8&7,21
5(3257,1*
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180%(5
180%(5
180%(5
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180%(5
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Enter the complete API Number of each qualifying well as assigned
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by the Wyoming Oil and Gas Conservation Commission. The API
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Number consists of County Number, Well Number, Side Track
Number, and Reservoir Number.
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Operators, enter mcf sold for each well, after deducting mcf
taken in-kind by interest owners who are reporting on their
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own behalf. Take in-kind interest owners enter mcf taken in-
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kind for each well.
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Enter the gross sales value for the well for the production period.
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Gross Sales Value includes all revenue relating to the production for
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the reported period, including tax reimbursements and all other
revenue received or credited to all interest owners not taking in-kind
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and reporting on their own behalf, and including all Federal, State, or
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Tribal royalty owner's interest.
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The taxable value equals the gross sales value for the well less any Exempt Royalty, Transportation, or Processing for the well.
Severance Tax Form 3002; page 2
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