Reporting Instructions Form For Oil And Gas Taxes - North Dakota Office Of State Tax Commissioner Page 30
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER
FORM T-12
600 E. BOULEVARD AVE., BISMARCK, ND 58505-0599
(August 2000)
OIL GROSS PRODUCTION AND OIL EXTRACTION TAX REPORT
ORIGINAL
PRODUCER
(Check One)
(Check One)
AMENDED
PURCHASER
YEAR/MONTH
(i.e., 1999, 2000) (i.e., 01, 12)
For Office Use Only
FEDERAL I.D. NUMBER
NAME
ADDRESS
PHONE
CITY
STATE/PROV.
ZIP CODE
For instruction booklet or forms contact the Office of State Tax Commissioner: 701-328-3593.
Hearing/speech impaired TTY users call Relay North Dakota 1-800-366-6888, ask for 701-328-3657.
You must attach all T-12 Worksheets to this Report.
GROSS PRODUCTION TAX
1.
Gross Production Tax Paid With Report ………………….….…………….…………...……………
Line 1 - Total from
Block 8 on T-12
2.
Penalty on Gross Production Tax ……………………………………………………
(See Instructions)…………….....…………
Worksheet
3.
Interest on Late Gross Production Tax …………..…….……
(See Instructions)………………..…………
4.
Total Due ……...……
(Add Lines 1, 2, and 3) …………………..……………………………………………...…………..………………………
OIL EXTRACTION TAX
5.
Oil Extraction Tax Paid With Report ……………...…………………...………………………………
Line 5 - Total from
Block 13 on T-12
6.
Penalty on Oil Extraction Tax ……………………………………………………………
(See Instructions)……………..……………
Worksheet
7.
Interest on Late Oil Extraction Tax …………...……………
(See Instructions)…..…………….…………
8.
Total Due …..………
(Add Lines 5, 6, and 7) ……………………………..…………………………...……………………………………
9.
Total Due With This Report ...…..
(Add Lines 4 and 8)………………………………….…………………..……………...………………….
10.
Tax Credits Claimed …….………..
(Enter as a positive value) ……………….….………………………………...……….………
11.
Total Gross Production and Oil Extraction Tax Remitted With This Report …………...……….……..
(Line 9 minus Line 10) ……......
If Line 11 Results in Credit Balance, Apply to:
Credit
Refund
I declare under penalties of North Dakota Century Code Section 12.1-11.02, which provides for a Class A misdemeanor for making a false statement in a
government matter, that this report, including any accompanying schedules and statements has been examined by me and to the best of my knowledge and
belief is a true, correct, and complete report.
Report Prepared by:
Date:
(Please Print or Type)
Please Do Not Write In This Space
Check here if PAYMENT has been
submitted electronically.
Page 28
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 28214 - Ag Commodity Processing Facility Investment Reporting - North Dakota Office Of State Tax Commissioner
Financial
Form 21986 - Sales & Use Tax Pre-audit Questionnaire - North Dakota Office Of State Tax Commissioner
Financial
Instructions For Telecommunications Gross Receipts Tax - North Dakota Office Of State Tax Commissioner - 2004
Financial
Form 28276 - Qualifi Ed Seed Capital Business Investment Reporting - North Dakota Office Of State Tax Commissioner
Financial
Form 401-es - Estimated Income Tax Estates And Trusts - North Dakota Office Of State Tax Commissioner - 2002
Financial
Form Afi - Angel Fund Investment Report -north Dakota Office Of State Tax Commissioner - 2011
Financial
Form 500 - Authorization To Disclose Tax Information And Designation Of Representative - North Dakota Office Of State Tax Commissioner
Financial
Form F22b - 2005 Voluntary Sales And Use Tax Return - North Dakota Office Of State Tax Commissioner
Financial
Related Categories
Parent category: Financial