Form Mt-07np - New Pool Initial Oil Or Gas Exemption Request Page 6

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Complete Production History Table for Initial Production Occurring On or After 7/1/12
Pages 1 & 4 are required to be filed when requesting an exemption for initial production occurring on or after 7/1/12.
A listing of the initial
full
6-month production history is
REQUIRED
to verify exempt status. An example on how to complete the
Production History is shown first and the table you will need to complete is located at the bottom of this page.
Example:
Shows how to complete a Production History Table using the initial production date of Aug 15, 2012.
Month / Day / Year
Month / Day / Year
Production
# of
Beginning Date
Ending Date
Producing Days
Jan
_0_ _1_,
20 _1_ _3_
to
Jan
_3_ _1_,
20 _1_ _3_
1499
31
Feb
_0_ _1_,
20 _1_ _3_
to
Feb
_1_ _5_,
20 _1_ _3_
750
14
Mar ___ ___,
20 ___ ___
to
Mar ___ ___,
20 ___ ___
SAMPLE
Apr ___ ___,
20 ___ ___
to
Apr
___ ___,
20 ___ ___
May ___ ___,
20 ___ ___
to
May ___ ___,
20 ___ ___
Jun
___ ___,
20 ___ ___
to
Jun
___ ___,
20 ___ ___
Jul
___ ___,
20 ___ ___
to
Jul
___ ___,
20 ___ ___
Aug _1_ _5_,
20 _1_ _2_
to
Aug
_3_ _1_,
20 _1_ _2_
625
17
Sep
_0_ _1_,
20 _1_ _2_
to
Sep
_3_ _0_,
20 _1_ _2_
1499
30
Oct
_0_ _1_,
20 _1_ _2_
to
Oct
_3_ _1_,
20 _1_ _2_
1495
31
Nov _0_ _1_,
20 _1_ _2_
to
Nov
_3_ _0_,
20 _1_ _2_
1400
30
Dec
_0_ _1_,
20 _1_ _2_
to
Dec
_3_ _1_,
20 _1_ _2_
1500
31
Total: 1.
8768
2.
184
Average Daily Production:
47.65
(Total of Column 1 divided by total of Column 2.)
Production History Table
(This table is required to be completed)
Month / Day / Year
Month / Day / Year
Production
# of Producing
Beginning Date
Ending Date
Days
Jan ___ ___, 20___ ___
to
Jan ___ ___, 20___ ___
______________
______________
Feb ___ ___, 20___ ___
to
Feb ___ ___, 20___ ___
______________
______________
Mar ___ ___, 20___ ___
to
Mar ___ ___, 20___ ___
______________
______________
Apr ___ ___, 20___ ___
to
Apr ___ ___, 20___ ___
______________
______________
May ___ ___, 20___ ___
to
May ___ ___, 20___ ___
______________
______________
Jun ___ ___, 20___ ___
to
Jun ___ ___, 20___ ___
______________
______________
Jul ___ ___, 20___ ___
to
Jul ___ ___, 20___ ___
______________
______________
Aug ___ ___, 20___ ___
to
Aug ___ ___, 20___ ___
______________
______________
Sep ___ ___, 20___ ___
to
Sep ___ ___, 20___ ___
______________
______________
Oct ___ ___, 20___ ___
to
Oct ___ ___, 20___ ___
______________
______________
Nov ___ ___, 20___ ___
to
Nov ___ ___, 20___ ___
______________
______________
Dec ___ ___, 20___ ___
to
Dec ___ ___, 20___ ___
______________
______________
TOTAL:
1. ______________
2. _______________
Average Daily Production:
_______________
(Total of Column 1 divided by total of Column 2.)
Mineral Tax web site:
KCC web site:
4

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