"Osage Tank Bottom Oil Report Form"

Osage Tank Bottom Oil Report Form is a 1-page legal document that was released by the U.S. Department of the Interior - Indian Affairs, Osage Agency and used nation-wide.

Form Details:

  • The latest edition currently provided by the U.S. Department of the Interior - Indian Affairs, Osage Agency;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more legal forms and templates provided by the issuing department.

ADVERTISEMENT
ADVERTISEMENT

Download "Osage Tank Bottom Oil Report Form"

Download PDF

Fill PDF online

Rate (4.7 / 5) 51 votes
Page background image
Bureau of Indian Affairs/Osage Agency
P.0. Box 1539
Pawhuska, OK 74056-1539
918-287-5740
TANK BOTTOM OIL REPORT FOR THE MONTH OF:
YEAR:
REPORTING COMPANY
TANK BOTTOM PURCHASER
Contact Person
Reporting Company
-
( )
NAME
&
ADDRESS
Phone Number
**
GROSS
NET
ROYALTY
$
DATE
TICKET
LEGAL
OPERATOR
BARRELS
BS&W
BARRELS
BARRELS
ROYALTY
I
I
I
II
I
GRAND TOTALS:
TOTAL NET BARRELS:
TOTAL ROYALTY BARRELS:
(1/6 of net barrels or as negotiated)
TOTAL ROYALTY:
( **
Royalty barrels x purchaser's price)
I certify that the foregoing report is true and correct:
SIGNATURE REQUIRED
A REPORT MUST BE SUBMITTED TO THIS OFFICE ON OR BEFORE THE 25TH OF EACH'MONTH
FOLLOWING SALES. REPORTS ARE REQUIRED EVEN THOUGH NO SALES OCCUR.
Bureau of Indian Affairs/Osage Agency
P.0. Box 1539
Pawhuska, OK 74056-1539
918-287-5740
TANK BOTTOM OIL REPORT FOR THE MONTH OF:
YEAR:
REPORTING COMPANY
TANK BOTTOM PURCHASER
Contact Person
Reporting Company
-
( )
NAME
&
ADDRESS
Phone Number
**
GROSS
NET
ROYALTY
$
DATE
TICKET
LEGAL
OPERATOR
BARRELS
BS&W
BARRELS
BARRELS
ROYALTY
I
I
I
II
I
GRAND TOTALS:
TOTAL NET BARRELS:
TOTAL ROYALTY BARRELS:
(1/6 of net barrels or as negotiated)
TOTAL ROYALTY:
( **
Royalty barrels x purchaser's price)
I certify that the foregoing report is true and correct:
SIGNATURE REQUIRED
A REPORT MUST BE SUBMITTED TO THIS OFFICE ON OR BEFORE THE 25TH OF EACH'MONTH
FOLLOWING SALES. REPORTS ARE REQUIRED EVEN THOUGH NO SALES OCCUR.