Reporting Instructions Form For Oil And Gas Taxes - North Dakota Office Of State Tax Commissioner Page 9

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T-12 WORKSHEET INSTRUCTIONS
Year & Month: Enter numerals, e.g. 200007 for July 2000.
Federal I.D. Number: Enter the reporting entity’s nine-digit Federal I.D. number.
Taxpayer Name: Enter the company name.
Page: Enter the current page number and the total number of pages.
Separate Worksheet Entries are Required in the Following Situations:
Condensate recovered from the wet gas stream (see Procedure for Reporting Condensate).
Oil produced from different reservoirs (i.e., pools).
Exempt and nonexempt oil reported in the same period.
API Number: The API, group, or unit number must be provided to process the lease detail information.
Sequence Number: The sequence number is required if there is more than one entry for an API, group, or unit number in order for
amended reports to be submitted and matched correctly (i.e., 001, 002, etc.).
Condensate: If reporting condensate, check yes; otherwise, leave this space blank.
Gross Production Tax:
Block 1. Barrels of Oil Purchased/Sold: Volume of oil purchased/sold (round to two decimal places).
Block 2. Value of Oil Purchased/Sold: Enter the gross value paid for the oil pursuant to the valuation provisions in N.D.C.C.
§ 57-51-02.3 (round to the nearest cent).
Block 3. Value of Exempt Government Royalties: Enter the value of exempt federal, state, other municipality, and Indian royalties
actually paid. The value should not exceed the amount calculated by taking the royalty percentage times the value of oil
purchased reported in Block 2.
Block 4. Taxable Value of Oil: Block 2 minus Block 3.
Block 5. Total Production Tax Due: Multiply Block 4 by the 5% gross production tax rate.
Block 6. Production Tax Previously Paid: On an original report, leave this space blank. On an amended report, enter the
production tax previously paid for an API, group, or unit and sequence number.
Block 7. Production Tax Paid by Others: Enter production tax paid by others.
Block 8. Production Tax Paid with Report: Block 5 minus Blocks 6 and 7.
NOTE: The total of Blocks 6, 7, and 8 must equal Block 5.
Page 7

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