INSTRUCTIONS FOR FORM 3000: SEVERANCE TAX REPORT GAS
USE Form 3000 TO REPORT GAS AND PLANT PRODUCTS INCLUDING PLANT
CONDENSATE (liquids separated at a processing plant).
REPORT ALL VOLUMES AND VALUES (EXCEPT TAX FIELDS) ROUNDED TO THE
NEAREST WHOLE NUMBER. TAX MUST BE REPORTED TO THE CENT.
Operator ID – Enter the Taxpayer's Operator ID as assigned by the Wyoming Oil and Gas
Conservation Commission (WOGCC), or as assigned by the Mineral Tax Division of the Wyoming
Department of Revenue.
Form Type -
Enter "O" for an Original Report. Enter "A" for an Amended Report.
Taxpayer Name – Enter Taxpayer's name. Do not enter a tax agent.
Contact Name - Enter the name of the person who can answer questions about this form.
Contact Phone Number - Enter the Contact person’s phone number.
Production Period - Month and year (mmyyyy). If you qualify as an annual filer, report production for
the entire year on one line as December (12yyyy).
Reporting Group Number - Enter the five digits Reporting Group Number assigned by the Mineral Tax
Division.
Rate Code - Enter the proper rate code identifier for the Reporting Group (see Rate Code Table).
Form 3000 is used to enter the combined Rate Code total for a specific Reporting Group. Individual
wells in a Reporting Group that qualify for well incentives must also be itemized on Form 3002,
Severance Tax Schedule Gas Well Incentive Reporting.
Gross Sales Volume - Operators, enter gross MCF sold, after deducting gross MCF taken in-kind by
interest owners who are reporting on their own behalf. Take in-kind interest owners enter gross MCF
taken in-kind.
Gross Sales Value - Enter the gross sales value for the production period. Gross Sales Value includes
all revenue relating to the production for the reported period, including tax reimbursements and all
other revenue received or credited to all interest owners not taking in-kind and reporting on their own
behalf, and including all Federal, State, or Tribal royalty owner's interest.
Exempt Royalty, Processing, and Transportation - Enter the value of the Federal, State, or Tribal
Royalty exemptions, combined with the total allowable Transportation costs, and the total allowable
Processing deduction.
Taxable Value - Enter the remainder of Gross Sales Value minus reported Exempt Royalty,
Transportation, and Processing.
Total Tax Due - Equals taxable value times the applicable tax rate, per the Rate Code Table.
Form 3000 Instructions
Page 2
Page Total - Enter the Sum of the Total Tax Due Column on this Form 2000.
Amendments are replacement filings not net change filings
A change in Rate Code requires BOTH an amended report for the originally reported rate code
and an original report for the new rate code.
For amendments Total Tax Due is the replacement amount and will not reflect previous tax
applied to your account. Be sure to account for tax previously applied to your account prior to
remitting current payment.
Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month
following the month of production. If a taxpayer’s total liability for severance tax was less than
$30,000 for the preceding calendar year, the taxpayer can report annually, by February 25 of the year
following the production year. All delinquent severance taxes are subject to penalty and interest.
Severance Tax Forms and payment in full must be post-marked by the 25th day of the second month
following the month of production. If a taxpayer’s total liability for severance tax was less than
$30,000 for the preceding calendar year, the taxpayer can report annually by February 25 of the year
following the production year. All delinquent severance taxes are subject to penalty and interest.
All forms must be signed and dated originals.
Severance Rate Code Table for Gas (as of 1/1/2000)
Rate
Severance
Rate Code Mineral
Type
Description
Tax Rate
BAS
Gas
Group
No Incentives (base rate)
.060
WRK
Gas
Well
Workover - Incremental
.020
REC
Gas
Well
Recompletion - Incremental
.020
NEW
Gas
Well
New Well
.020
WLD
Gas
Well
Wildcat
.020
NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must
complete and attach 3002, Severance Tax Schedule.
The mailing address for all Department of Revenue mineral forms is:
Wyoming Department of Revenue
Mineral Tax Division
122 West 25th Street
Cheyenne, WY 82002-0110
10/18/2001
Severance Tax Form Instructions
6WDWH RI :\RPLQJ
:HVW WK 6WUHHW
&KH\HQQH :< O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
2
3
Contact Phone Number:
352'8&7,21
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Taxpayer’s Operator ID as assigned by the
Wyoming Oil and Gas Conservation
Commission (WOGCC), or as assigned by
the Mineral Tax Division.
4
727$/ 7$; '8(
75$163257$7,21
NOTE:
Taxpayer’s name. Do not enter
an For amended returns (Form
Type ‘A’) report REPLACEMENT
agent’s name here.
VALUES ONLY.
Contact Person or Agent's telephone number including area code and
extension.
NOTE: A change in Rate Code
requires BOTH an amended report
for the originally reported rate code
and an original report for the
new rate code.
5
6
7
DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
1
3000
SEVERANCE TAX REPORT
Enter ‘O’ for an original
GASreport. Enter ‘A’ for an
amended report
'HSDUWPHQW RI 5HYHQXH
Name of the person, agent, or agency responsible for completing this report who can answer
questions regarding this report.
NOTE: For amendments Total Tax
Due is the replacement amount and
not reflect previous tax applied
Use Form 3000 to report gas and plant products including plant condensatewill
(liquids
your
account. Be sure to account
to
separated at a main processing plant).
for tax previously applied to your
account prior to remitting the
payment.
Always report volumes and values except Total Tax Due rounded to the nearest
whole
8
9
10
11
number. Total Tax Due must be reported to the cent.
12
MTSII 10/8/01
PAGE TOTAL:
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
Severance Tax Form 3000; page 1
Severance Tax Form Instructions
6WDWH RI :\RPLQJ
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
&KH\HQQH :< DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
Contact Phone Number:
352'8&7,21
5(3257,1*
5$7(
*5266 6$/(6
*5266 6$/(6
(;(037 52<$/7<
7$;$%/(
3(5,2'
*5283
&2'(
92/80(
9$/8(
352&(66,1* $1'
9$/8(
PP\\\\
180%(5
1
3000
SEVERANCE TAX REPORT
GAS
727$/ 7$; '8(
75$163257$7,21
NOTE: For amended returns (Form
Type ‘A’) report REPLACEMENT
VALUES ONLY.
Month and year (mmyyyy). If you are an annual filer
report production for the entire year as December
(12yyyy).
2
3
4
Enter the five digit Reporting Group Number
assigned by the Mineral Tax Division.
5
Enter the proper Rate Code Identifier for the Reporting
Group (see Rate Code Table). Form 3000 is used to enter
the combined Rate Code total for a specific Reporting
Group. Individual wells in a Reporting Group that qualify
for well incentives must also be itemized on Form 3002.
6
7
8
9
Operators enter mcf sold, after deducting mcf
taken in-kind. Take In-Kind interest owners enter
mcf taken in-kind.
10
11
NOTE: A change in Rate Code
requires BOTH an amended report
for the originally reported rate code
and an original report for the
new rate code.
NOTE: For amendments Total Tax
Due is the replacement amount and
will not reflect previous tax applied
to your account. Be sure to account
for tax previously applied to your
account prior to remitting the
payment.
12
MTSII 10/8/01
PAGE TOTAL:
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
Severance Tax Form 3000; page 2
Severance Tax Form Instructions
6WDWH RI :\RPLQJ
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
3000
SEVERANCE TAX REPORT
GAS
&KH\HQQH :< DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
Contact Phone Number:
352'8&7,21
5(3257,1*
5$7(
*5266 6$/(6
*5266 6$/(6
(;(037 52<$/7<
7$;$%/(
3(5,2'
*5283
&2'(
92/80(
9$/8(
352&(66,1* $1'
9$/8(
PP\\\\
180%(5
727$/ 7$; '8(
75$163257$7,21
NOTE: For amended returns (Form
Type ‘A’) report REPLACEMENT
VALUES ONLY.
1
Enter the gross sales value for the production
2 period. Gross Sales Value includes all
revenue relating to the production for the
3 reported period, including tax
and all other revenue
4 reimbursements
received or credited to all interest owners not
5 taking in-kind and reporting on their own
behalf, and including all Federal, State, or
6 Tribal royalty owner's, not taking royalty inkind, interest.
Enter the remainder of
Gross Sales Value minus
Exempt Royalty and
Transportation.
NOTE: A change in Rate Code
requires BOTH an amended report
for the originally reported rate code
and an original report for the
new rate code.
7
8
NOTE: For amendments Total Tax
Due is the replacement amount and
will not reflect previous tax applied
to your account. Be sure to account
for tax previously applied to your
account prior to remitting the
payment.
Enter the value of the Federal, State, or Tribal
Royalty exemptions, combined with the total
allowable transportation costs and the total
allowable processing deduction.
9
10
11
12
MTSII 10/8/01
PAGE TOTAL:
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
Severance Tax Form 3000; page 3
Severance Tax Form Instructions
6WDWH RI :\RPLQJ
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
&KH\HQQH :< DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
1
3000
SEVERANCE TAX REPORT
GAS
Contact Phone Number:
352'8&7,21
5(3257,1*
5$7(
*5266 6$/(6
*5266 6$/(6
(;(037 52<$/7<
7$;$%/(
3(5,2'
*5283
&2'(
92/80(
9$/8(
352&(66,1* $1'
9$/8(
PP\\\\
180%(5
727$/ 7$; '8(
75$163257$7,21
Equals the taxable value times the applicable tax rate per the Rate Code Table.
2
3
4
5
6
7
8
NOTE: For amended returns (Form
Type ‘A’) report REPLACEMENT
VALUES ONLY.
Severance Rate Code Table for Gas (as of 1/1/2002)
Rate
Severance
Rate Code Mineral
Type
Description
Tax Rate
BAS
Gas
Group
No Incentives (base rate)
.060
WRK
Gas
Well
Workover - Incremental
.020
REC
Gas
Well
Recompletion - Incremental
.020
NEW
Gas
Well
New Well
.020
WLD
Gas
Well
Wildcat
.020
NOTE: Reporting Groups containing wells that qualify for well incentives, Rate Type “Well”, must
complete and attach 3002, Severance Tax Schedule.
9
10
11
MTSII 10/8/01
NOTE: A change in Rate Code
requires BOTH an amended report
for the originally reported rate code
and an original report for the
new rate code.
NOTE: For amendments Total Tax
Due is the replacement amount and
will not reflect previous tax applied
to your account. Be sure to account
for tax previously applied to your
account prior to remitting the
payment.
PAGE TOTAL:
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
Severance Tax Form 3000; page 4
Severance Tax Form Instructions
6WDWH RI :\RPLQJ
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
&KH\HQQH :< O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
2
3
4
Contact Phone Number:
352'8&7,21
5(3257,1*
5$7(
*5266 6$/(6
*5266 6$/(6
(;(037 52<$/7<
7$;$%/(
3(5,2'
*5283
&2'(
92/80(
9$/8(
352&(66,1* $1'
9$/8(
PP\\\\
180%(5
7
8
9
727$/ 7$; '8(
75$163257$7,21
Severance Tax Forms and payment in full must be post-marked by the 25th day of
the second month following the month of production. If a taxpayer’s total liability
for severance tax was less than $30,000 for the preceding calendar year, the
taxpayer can report annually, by February 25 of the year following the production
year. All delinquent severance taxes are subject to penalty and interest.
5
6
DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
1
3000
SEVERANCE TAX REPORT
GAS
The mailing address for all Department of Revenue mineral forms is:
Wyoming Department of Revenue
Mineral Tax Division
122 West 25th Street
Cheyenne, WY 82002-0110
NOTE: For amended returns (Form
Type ‘A’) report REPLACEMENT
VALUES ONLY.
NOTE: A change in Rate Code
requires BOTH an amended report
for the originally reported rate code
and an original report for the
new rate code.
NOTE: For amendments Total Tax
Due is the replacement amount and
will not reflect previous tax applied
to your account. Be sure to account
for tax previously applied to your
account prior to remitting the
payment.
10
11
All paper forms PAGE
must beTOTAL:
signed and dated originals.
MTSII 10/8/01
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date
Severance Tax Form 3000; page 5
6WDWH RI :\RPLQJ
3000
SEVERANCE TAX REPORT
GAS
'HSDUWPHQW RI 5HYHQXH
:HVW WK 6WUHHW
&KH\HQQH :< DEPARTMENT OF REVENUE USE ONLY:
Operator ID:
O - Original
A - Amended
Form Type:
Taxpayer Name:
Contact Name:
Contact Phone Number:
352'8&7,21
5(3257,1*
5$7(
*5266 6$/(6
*5266 6$/(6
(;(037 52<$/7<
7$;$%/(
3(5,2'
*5283
&2'(
92/80(
9$/8(
352&(66,1* $1'
9$/8(
PP\\\\
180%(5
727$/ 7$; '8(
75$163257$7,21
NOTE: For amended returns (Form
Type ‘A’) report REPLACEMENT
VALUES ONLY.
1
2
3
NOTE: A change in Rate Code
requires BOTH an amended report for
for the originally reported rate code
and an original report for the
new rate code.
4
5
6
7
NOTE: For amendments Total Tax
Due is the replacement amount and
will not reflect previous tax applied to
your account. Be sure to account
for tax previously applied to your
account prior to remitting the current
payment.
8
9
10
11
12
PAGE TOTAL:
MTSII 10/8/01
I declare under penalty of perjury that I have examined this return and, to the best of my knowledge and belief, it is correct and complete.
Authorized Signature
Title
Date