O&G Production-1
Rev. 9/14
PRIVILEGE TAX
8%6%4%
WELLS PERMITTED 7/1/96 THRU 6/30/02
PRODUCTION TAX PRIVILEGE TAX
1% 2% 3%
TOTAL AMOUNT REMITTED
TOTAL
Check here if any of the above information has changed since your last return was filed
Check here if filing by Electronic Funds Transfer (EFT)
Check here if filing an amended return
ALABAMA DEPARTMENT OF REVENUE
BUSINESS & LICENSE TAX DIVISION
Oil and Gas Producers Tax Return
PLEASE TYPE OR PRINT IN BLUE OR BLACK INK
PRODUCTION TAX
COUNTY / MUNICIPALITY
Subtotal
Interest
Penalty
TOTALS
2%
Taxpayer _______________________________________________________________ FEIN ____________________________
Address __________________________________________________________________________________________________
_________________________________________________________________________________________________________
Contact Person ________________________________________________________ Telephone (______)___________________
PRODUCTION PERIOD
(MONTH / YEAR)
I hereby certify under penalty of perjury that I am duly authorized to make this tax return; that the information herein contained is true and correct and same is shown by the records of the
identified producer; and that the amount of taxes accompanying this return is the true and correct amount of taxes due the State of Alabama by this producer.
Signed _________________________________________________________ Title ___________________________________________________
Reports and tax payments are due on or before the fifteenth day of the second month following the month of production.
Returns and payments made after due date are subject to penalty and interest charges.
ALL PREVIOUS FORMS ARE OBSOLETE AND SHOULD BE DESTROYED.
MAIL RETURNS TO: Alabama Department of Revenue
Severance & License Section
P.O. Box 327560
Montgomery, AL 36132-7560
TELEPHONE: (334) 353-7827
FAX: (334) 353-1809
EFT Assistance: 1-800-322-4106 (option 7)
Additional forms and information may be obtained at www.revenue.alabama.gov
.
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Instructions On Filing The
Oil and Gas Producers Return
All producers who have an interest in an oil or gas well in the state of Alabama are required to file a monthly producer’s
return regardless of who has responsibility for remitting the actual severance tax. The volumes reported and taxable value
should be actual deliveries and not entitlement. Each month’s related production and sales should be filed on a separate
return. Corrections should be made on a separate amended return for each production month by replacing the previously
filed return with a replacement return and reporting any additional tax due in the “TOTAL TAX REMITTED box.
The “Amended Return” box must be checked on the O&G Production-1 form.
O&G Production-1 Form
The O&G Production-1 form is a cover sheet for the monthly severance tax return (form O&G Production-2). The individual
counties, municipalities and the tax rates are consolidated on this sheet from the O&G Production-2 form(s). The inventories,
production, and sales are reconciled for all the wells. All purchasers of the products are listed with their respective volumes
and values, for the quantities purchased.
FEIN: Federal Employer’s Identification Number issued to the company by the Federal Government.
Taxpayer and Mailing Address: Name the company is doing business under in the state of Alabama and the address used.
Contact Person and Telephone: Person to contact and their telephone number when questions regarding a tax return arise.
Production Period Month/Year: The production period for which the report is being filed.
O&G Production-2 Form
The O&G Producer-2 form is a schedule which lists the individual wells separated by county, municipality and privilege tax
rate. Each county, municipality and different applicable privlege tax rate is required to be on a separate form.
Well/Unit Name: The name of the well or unit as registered with the Alabama State Oil and Gas Board. Note: A unitized
field should be reported as unit volumes versus the individual wells.
Permit Number: The number assigned to the well/unit by the Alabama State Oil and Gas Board.
Production Code: Codes representing the commodity the company is selling and remitting severance tax on for the produc-
ers.
100% Production: This is the 100% production applicable to the well. Note: This is not just the producer's interest in the well.
Non-operators, if this data is not available, please write in “NON-OP”.
Purchasers Liability Volume: The volume the purchaser is responsible for remitting taxes on for the producers.
Purchasers Liability Value: The amount paid for the volumes on which the purchaser is responsible for remitting taxes on
for the producers.
Producers Liability Volume: The volume the producer is liable for remitting taxes on.
Producers Liability Value: The gross value for which the producer is receiving for the product. This value should equate
to the purchaser's remittance statement.
Exempt Interest: The percentage amount which is exempt from Severance Tax which has been approved by the Alabama
Department of Revenue, Severance & License Section. Approval must be granted prior to deduction being taken.
Other: Any other deductions which are not subject to severance taxes.
Producers Net Taxable Value: The Purchased Value less the deductions.
TIK Volume: The volume applicable to other working interest owners who are taking their interest in kind and remitting
individual severance taxes. These volumes are actual deliveries not entitlement, and are listed by producer.
TIK Producer: The name of the producer taking share of production in kind.
Gals Bbls MCF
Gals Bbls MCF
Gals Bbls MCF
Gals Bbls MCF
Gals Bbls MCF
GAS
OIL / CONDENSATEPLANT PRODUCTS
Beginning
Production during month
Sold during month
Used during month
Closing inventory
VALUE
GALS / BBLS / MCF
SOLD
PRODUCT
CODE
PURCHASERS
Wells in operation: ____________
Check here if you are a Non-Operator