Form 700 Monthly Remittance Report printable pdf download

Form 700

MONTHLY REMITTANCE REPORT – OIL AND GAS SEVERANCE TAX

COMANCHE NATION TAX COMMISSION

P.O. BOX 1917

1915 E. GORE BLVD.

LAWTON, OKLAHOMA 73502

1. Reporting Period: _____________, 20 ____

2. ____ Original Report ____ Amended Report

3. Lessee Information:

a. Bureau of Indian Affairs Lease Number: _____________________

b. Comanche Nation Allotment Number: ______________ Amount of acres leased________________

c. Lessee's Comanche Nation License Number: _______________

d. Lessee's Name and Address:

____________________________________________________________________________________

________________________________________________

e. Date of Lease, Sublease, or Assignment (if applicable): __________________________

f. If Subleased or Assigned, Name of Original Lessee: ________________________________________

4. Legal Description of Producing Unit:

_______________________________________________________________________________________

___________________________________________________

5. Operator Information:

a. Operator's Name and Address:

____________________________________________________________________________________

________________________________________________

b. Operator's Comanche Nation License Number: ________________

6. Date of Unitization Agreement (if applicable): ____________________________________

7. If Tax is to be Paid by Person Other than the Lessee:

a. Taxpayer's Name and Address:

____________________________________________________________________________________

________________________________________________

b. Explain Relationship to Lessee:

____________________________________________________________________________________

________________________________________________

FORM 700

MONTHLYREMITTANCEREPORT.docx

Form 700 Monthly Remittance Report