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North Dakota T 12 Template

The North Dakota T 12 form is a crucial document used for reporting oil gross production and oil extraction taxes in the state. This form must be completed by producers and purchasers to accurately reflect their tax liabilities. Understanding how to fill out this form correctly is essential for compliance and to avoid penalties.

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The North Dakota T 12 form serves as a crucial document for those involved in the oil industry, particularly for reporting oil gross production and oil extraction taxes. It is essential for producers and purchasers to accurately complete this form to ensure compliance with state tax regulations. The form requires specific information, including the federal identification number, the name and address of the reporting entity, and the year and month of the report. Taxpayers must also calculate and report the gross production tax and oil extraction tax, including any penalties or interest due for late payments. Additionally, the T 12 form necessitates the attachment of detailed worksheets that outline oil purchases and sales, which contribute to the overall tax calculations. By providing a comprehensive overview of the taxes owed, the T 12 form helps to maintain transparency and accountability within the oil sector. Completing this form accurately is vital, as misstatements can lead to penalties under North Dakota law. Ultimately, the T 12 form not only facilitates the collection of taxes but also supports the state's efforts in managing its natural resources effectively.

Sample - North Dakota T 12 Form

		NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER
		600 E. BOULEVARD AVE., BISMARCK, ND 58505-0599
	OIL GROSS PRODUCTION AND OIL EXTRACTION TAX REPORT
			ORIGINAL	PRODUCER
			ORIGINAL	PRODUCER
			(Check One)	(Check One)
			(Check One)	(Check One)
YEAR/MONTH			AMENDED	PURCHASER
YEAR/MONTH
	(i.e., 1999, 2000)	(i.e., 01, 12)
FEDERAL I.D. NUMBER
NAME
ADDRESS				PHONE
CITY			STATE/PROV.	ZIP CODE

FORM T-12

(August 2000)

For Office Use Only

For instruction booklet or forms contact the Office of State Tax Commissioner: 701-328-3593. Hearing/speech impaired TTY users call Relay North Dakota 1-800-366-6888, ask for 701-328-3657.

You must attach all T-12 Worksheets to this Report.

GROSS PRODUCTION TAX

1. Gross Production Tax Paid With Report ………………….….…………….…………...…………

2. Penalty on Gross Production Tax ………………………… (See Instructions)…………….....………

3. Interest on Late Gross Production Tax …………..…….… (See Instructions)………………..………

4. Total Due ……...…… (Add Lines 1, 2, and 3) …………………..……………………………………………...…………..……………………

Line 1 - Total from

Block 8 on T-12

Worksheet

OIL EXTRACTION TAX

5.Oil Extraction Tax Paid With Report ……………...…………………...……………………………

6.Penalty on Oil Extraction Tax ……………………………… (See Instructions)……………..…………

7.Interest on Late Oil Extraction Tax …………...…………… (See Instructions)…..…………….………

8.Total Due …..……… (Add Lines 5, 6, and 7) ……………………………..…………………………...……………………………………

Line 5 - Total from Block 13 on T-12 Worksheet

9.	Total Due With This Report ...….. (Add Lines 4 and 8)………………………………….…………………..……………...…………………
10.	Tax Credits Claimed …….……….. (Enter as a positive value) ……………….….………………………………...……….………
11.	Total Gross Production and Oil Extraction Tax Remitted With This Report …………...……… (Line 9 minus Line 10) ……
	If Line 11 Results in Credit Balance, Apply to:	Credit	Refund
	If Line 11 Results in Credit Balance, Apply to:	Credit	Refund

I declare under penalties of North Dakota Century Code Section 12.1-11.02, which provides for a Class A misdemeanor for making a false statement in a government matter, that this report, including any accompanying schedules and statements has been examined by me and to the best of my knowledge and belief is a true, correct, and complete report.

Report Prepared by:

Date:

(Please Print or Type)

Please Do Not Write In This Space

Check here if PAYMENT has been

submitted electronically.

North Dakota Statement of Oil Purchases/Sales

T-12 WORKSHEET - OIL

Gross Production & Oil Extraction Tax

(August 2000)

YEAR/MONTH

(i.e., 1999, 2000)

(i.e., 01, 12)

FEDERAL I.D. NUMBER

TAXPAYER NAME

Page

Gross Production Tax

Oil Extraction Tax

Barrels of Oil

Value of Oil

Value of Exempt

Taxable Value of Oil

Pool

Well

Taxable Value of Oil

Other Party

Purchased/Sold

Government

Federal I.D.

Purchased/Sold

(Block 2 - Block 3)

Code

(Same as Block 4)

(Round to two Places)

Royalties

Number

Oil

Posting

Additional

Transportation

Other

Total Production Tax Due

Total Extraction Tax Due

Gravity

Code

Value

Deduction

Deductions

(5% of Block 4)

(4% or 6.5% of Block 9)

Production Tax

Extraction Tax

Previously Paid

API Number:

Sequence #

Condensate

Production Tax Paid

Extraction Tax Paid

(

)

YES

By Others

Production Tax Paid

Extraction Tax Paid

Well or Lease Name:

with Report

Oil

Posting

Additional

Transportation

Other

Total Production Tax Due

Total Extraction Tax Due

Gravity

Code

Value

Deduction

Deductions

(5% of Block 4)

(4% or 6.5% of Block 9)

Production Tax

Extraction Tax

Previously Paid

API Number:

Sequence #

Condensate

Production Tax Paid

Extraction Tax Paid

(

)

YES

By Others

Production Tax Paid

Extraction Tax Paid

Well or Lease Name:

with Report

Oil

Posting

Additional

Transportation

Other

Total Production Tax Due

Total Extraction Tax Due

Gravity

Code

Value

Deduction

Deductions

(5% of Block 4)

(4% or 6.5% of Block 9)

Production Tax

Extraction Tax

Previously Paid

API Number:

Sequence #

Condensate

Production Tax Paid

Extraction Tax Paid

(

)

YES

By Others

Production Tax Paid

Extraction Tax Paid

Well or Lease Name:

with Report

Page Total

Sum of Block 8:

Sum of Block 13:

▼ PDF Form

Document Specs

Fact Name	Description
Purpose of the T-12 Form	The North Dakota T-12 form is used to report oil gross production and oil extraction taxes by producers and purchasers of oil.
Governing Law	This form is governed by the North Dakota Century Code, specifically related to taxation of oil production and extraction.
Submission Requirements	Taxpayers must attach all T-12 Worksheets to the report when submitting the form to the Office of State Tax Commissioner.
Contact Information	For assistance, individuals can contact the Office of State Tax Commissioner at 701-328-3593 or use TTY services for hearing/speech impaired users.
Penalties and Interest	Late payments may incur penalties and interest, which are detailed in the instructions accompanying the form.
Filing Frequency	The T-12 form must be filed annually, specifying the year and month for which the report is being submitted.

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