Form 330 - Tax Credit Summary And Certificate Request For Oil And Gas Production Tax Credits Page 8

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330

Alaska

Oil and Gas Production Tax Credits

under AS 43.55.023

Schedule C: Election for a Carried-forward Annual Loss Credit under AS 43.55.023(b)

Federal EIN

Date of Claim

Tax Period

Taxpayer Name

For segments OTHER than producing properties in Cook Inlet or Gas Used in State, complete 1-21.

Qualified Capital Expenditures and Well Lease Expenditures NOT Related to Exploration [under AS 43.55.023(a)(1) &

(I)(1)]

Qualified Capital Expenditures and Well Lease Expenditures Related to Exploration [under AS 43.55.023(a)(2) & (I)(2)]

Total Qualified Capital Expenditures and Well Lease Expenditures

$ 0

Enter Total Taxable Production in Btu Equivalent Barrels for the Calendar Year

bbls

Multiply line (4) by $.30 per Btu Equivalent Barrel and enter the result

$ 0

Subtract line (5) from line (3) and enter result, Adjusted Qualified Capital Expenditures

$ 0

Qualified Capital Expenditure Overhead Rate

0.00%

(3% before March 1, 2010, or 4.5% on or after March 1, 2010, per 15 AAC 55.270 & .271)

Qualified Capital Expenditure Overhead Allowance, multiply line (6) by line (7)

$ 0

Total Lease Expenditures other than Capital, Overhead, and Payments of or in Lieu of Taxes

Overhead Rate for Lease Expenditures other than Capital and Overhead

0.00%

(9% before March 1, 2010, or 4.5% on or after March 1, 2010, per 15 AAC 55.270 & .271)

Overhead Allowance for Lease Expenditures other than Capital and Overhead, multiply line (9) by line (10)

Payment of or in Lieu of Taxes

Total Lease Expenditures, add lines (6)+(8)+(9)+(11)+(12)

$ 0

Destination Value

Less Transportation, Quality Bank Adjustments and Other Adjustments

Gross Value at the Point of Production (GVPP), line (14) less line (15)

Lease Expenditures, line (13)

$ 0

Other Adjustments to Lease Expenditures

Excess Lease Expenditures, line (16) less line (17) and line (18)

$ 0

Credit Percentage Allowed (20% before July 1, 2007 or 25% on or after July 1, 2007)

0.00%

Credit for Annual Loss Carry-forward, multiply line (19) by (20)

Total credit claimed carried to Page 1, Alaska Tax Credit Summary and Certificate Request Form

If producing in Cook Inlet or for Gas Used In State, complete & attach the annual tax return & enter resulting credit for

annual loss carry-forward.

$___________________

Note: for the 2010 Annual Loss Calculation, Please complete this form twice - once for January and February expenditures using the 3% and 9% overhead

rates and the second form for the calculation of March - December expenditures using the 4.5% overhead rate. Please include one of the calculations for

“Total Lease Expenditures” to line 18 of Schedule C “Other Adjustments” so it links correctly to the Summary Page of this form.

This form is available online at

Submit completed applications via the Tax Division’s Online Tax

Information System (OTIS) at

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0405-330 Rev 03/19/13 - page 8