Gas Severance Tax Return - Louisiana Department of Revenue

R-9036-L (7/05)Gas Severance Tax Return - Lease DetailG-1dTaxpayer Services DivisionSeverance Taxes SectionP. O. Box 201Baton Rouge, LA 70821-0201Page _______ of _______File original of this return only.5903Reporting company nameReporting company address, city, state, ZIPReporting company number Revenue Account NumberTaxable PeriodThis return is due by the 25th day of the second month following the taxable period and becomesdelinquent on the first day thereafter. If the due date falls on a weekend or holiday, the return is due on thenext business day and becomes delinquent on the first day thereafter. See special instructions for additionalfiling requirements for taxpayers with liabilities equal to or in excess of $15,000. Report allvolumes in MCF (15.025 pounds absolute pressure and 60°F).Field nameProducer nameLease and Well namePlant nameConservation codesParish Field Producer LeasePlantcodeTaxpayercodeTaxratecodeGross gas productionExclusionsMCF Code MCF Code MCF Code MCFNet taxable MCFTax and interestTotals (to be entered on last page of returnif more than one page is used)

R-9036-L (7/05)Instructions for Form Sev. G-1dReporting company name and addressSelf-explanatory.Revenue Account NumberThis is your 10-digit Louisiana Tax NumberReporting company numberProducer code number assigned by the Louisiana Office ofConservation, or number assigned by the Department ofRevenue, Severance Tax Division, to taxpayers who are notproducers.Taxable periodPeriod for which tax is due. Volumes and taxes for morethan one taxable period are not to be combined; they areto be reported separately.Field, producer, lease, plant namesSelf-explanatory.Parish, field, producer, lease codesCodes assigned by the Louisiana Office of Conservation.Plant codeCode assigned by the Louisiana Office of Conservation.Taxpayer codeProducer code assigned by the Louisiana Office ofConservation, or number assigned by the Department ofRevenue to taxpayers who are not producers.Tax rate codeCode assigned by the Department of Revenue to designateapplicable tax rate per MCF by category. (See Tax RateCodes at right.)Gross gas productionProducer must report all production for each property asreported on the OGP to the Louisiana Office ofConservation. Responsible taxpayers, if other than producer,must report gross volumes for which they are to account.ExclusionsGas volume lawfully exempt from tax.1. Code: Code assigned by the Department ofRevenue at right.2. MCF: Volume of gas claimed for preceding exclusioncode.Net taxable MCFet taxable MCFGross production plus and/or minus exclusions reported.Tax and interestNet taxable MCF times applicable tax rate equals amountof tax due. Delinquent penalty is 5 percent of tax liability foreach 30 days or fraction thereof, not to exceed 25 percent.Interest accrues at the rate of 1.25 percent per month onunpaid tax from due date to date of payment. Tax, penalty,and interest must be reported as separate items.TotalsTo be entered only on last page of G-1d if multiple pagesare used.Special Instructions1. In any case where a taxpayer’s average monthly tax liabilityfor the preceding calendar year equals or exceeds$15,000, payment must be made by one of the followingmethods:a. By electronic funds transfer to be received by theDepartment of Revenue on or before the twenty-fifthday of the second month following the month towhich the tax is applicable. A separate transfer mustbe made for each return.b. By delivery of the tax return and full payment ininvestible funds of the amount shown on the return,in person, or by courier to the Department ofRevenue on or before the twenty-fifth day of the secondmonth following the month to which the tax isapplicable. Such payment must be received beforethe end of the business day.2. A taxpayer who is not complying with the provisions ofLouisiana Revised Statute 47:1519 will be considereddelinquent and will be subject to penalties and interestas provided in R.S. 47:1601 and 1602.NoteA parish summary (G-1s) must accompany this return.Tax Rate CodesTaxable gas categoryFull rate – capable gas7/01 – 6/027/02 – 6/037/03 – 6/047/04 – 6/057/05 – 6/06Tax rateper MCF19.9¢12.2¢17.1¢20.8¢25.2¢Tax ratecodeIncapable rate – oil well gas 3¢ 2Incapable rate – gas well gas 1.3¢ 3Penalty and interest — 6Approved contracts at less than52¢ per MCFDeep well. Production from a welldrilled to a true vertical depth ofmore than 15,000 feet and commencesafter July 31, 1994. This wellmust be approved as a deep well bythe Office of Conservation.Horizontal well. Production from anapproved horizontal well or horizontallyrecompleted well from whichproduction commences after July 31,1994. This well must be approved bythe Office of Conservation.Inactive well. Production from anapproved well that has been inactivefor two or more years or having 30days or less of production during thelast two years. Application must bemade to the Office of Conservationprior to production, during the periodbeginning July 31, 1994, and endingJune 30, 2000, for a 5 year severancetax exemption; for the period beginningJuly 1, 2002, and ending December31, 2004 for a 2 year severance taxexemption, and for the period beginningJanuary 1, 2005 and ending June30, 2010, for a 5 year severance taxexemption. This well must beapproved by the Office ofConservation.Tertiary recovery projects approvedby the Office of Conservation.17¢ 7— D— H— I— TExclusion CodesNature of exclusionInjected into the formation in the State ofLouisianaProduced without the State of Louisiana andwhich has been injected into the earth in theState of LouisianaProduced Water InjectionIncentive Tax Rate Code Legend–Approved Projects OnlyTaxable gas categoryProduced water – Full rate7/01 – 6/027/02 – 6/037/03 – 6/047/04 – 6/057/05 – 6/06Produced water – Incapable rate –Oil well gas.Produced water – Incapable rate –Gas well gas.Tax rateper MCF15.9¢9.8¢13.7¢16.6¢20.2¢ExclusioncodeVented or flared from oil and gas wells 3Used for fuel in connection with the operationand development for the production ofoil or gas in the field where producedUsed in the manufacture of carbon black 7United States Government royalty 8Gas to be accounted for by working interestowner or purchaser or others (Identify taxpayerin taxpayer code column.)Measurement difference (not to includeover/short delivery accounts)Gas used for the production of naturalresources in the State of Louisiana1249XNTax ratecode1P2.4¢ 2P1.04¢ 3P