Lat 12 - Personal Property Report - Oil And Gas Property Page 3

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LAT 12 --- ATTACHMENT A
PRODUCTION DATA
WELL SERIAL NUMBER:
Year/Month
Oil Wells
Gas Wells
BBLS. Oil
MCF Gas
MCF Gas
BBLS.
Condensate
2013
2014
2015/01
/02
/03
/04
/05
/06
/07
/08
/09
/10
/11
/12
THIS LAT 12 – ATTACHMENT “A” MUST BE COMPLETED TO RECEIVE CREDIT FOR
FUNCTIONAL AND/OR ECONOMIC OBSOLESENCE OR SHUT-IN STATUS.
Note: Test data or other evidence from field operations may be used to
allocate total lease production on multiple well leases.
Is casinghead gas sold?
Yes_____
No_____
Is this well shut-in?
Yes_____
No_____
12/28/2015
REVISION DATE:

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