OFFICE OF STATE TAX COMMISSIONER
Schedule T-82
OPERATOR'S SCHEDULE OF TAKE IN-KIND OWNERS
(August 2000)
Effective Year/Month
Page ____ of ____
(i.e., 1999, 2000)
(i.e., 01, 12)
Federal I.D. No.
Operator's Name
Property Name
Group/API Number
THE OPERATOR MUST PROVIDE (FOR EACH TAKE IN-KIND INTEREST OWNER) THE NAME, ADDRESS, AND
PERCENTAGE OF PRODUCTION TAKEN.
Company Name
Mailing Address
Percentage
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
100.00000%
If necessary, attach a separate page to list additional working interest owners.
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