Severance Tax Schedule (Severance Tax Form 3002) - Gas Well Incentive Reporting Page 3
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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:
Severance Well Rate Code Table for Gas (as of 1/1/2002)
API NUMBER
352'8&7,21
5(3257,1*
5$7(
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6,'(75$&.
5(6(592,5
Rate Code
Mineral
Rate Type
Description
3(5,2'
*5283
&2'(
180%(5
180%(5
180%(5
180%(5
*5266 6$/(6 92/80(
*5266 6$/(6 9$/8(
7$;$%/( 9$/8(
PP\\\\
180%(5
WRK
Gas
Well
Workover - Incremental
1
REC
Gas
Well
Recompletion - Incremental
2
NEW
Gas
Well
New Well
WLD
Gas
Well
Wildcat
3
4
5
The cumulative total of all qualifying wells listed on Form 3002 for a particular Production Period, Reporting
Group Number, and Rate Code must total to Form 3000 for the same Production Period, Reporting Group Number,
6
and Rate Code.
7
The mailing address for all Department of Revenue mineral forms is:
8
Wyoming Department of Revenue
9
Mineral Tax Division
10
122 West 25th Street
Cheyenne, WY 82002-0110
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12
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All paper forms must be signed and dated originals.
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
MTS2 12/16/99
Severance Tax Form 3002; page 3
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