FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

This presentation will assist you in the completion of the Form 1139. The application for enhance recovery project/gross production tax exemption.

Date of Last Revision: 2009

Rule Requirement: 10-21-75

Explanation of Form: Operators shall file one copy of Form 1139 with the required attachments with the Technical Services Department of the Conservation Division. [Reference 165:10-21-75 through 165:10-21-80]

Question concerning this Form: For more information contact Technical Review at (405) 522-4451.

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

APPLICANT’S NAME

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

OTC/OCC OPERATOR NUMBER

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

APPLICANT’S MAILING ADDRESS, PHONE NUMBER, CITY, STATE, ZIP CODE AND FAX NUMBER

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

ENHANCE RECOVERY PROJECT

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

OTC PRODUCTION UNIT NUMBER

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

LEGAL LOCATION (INCLUDE) – - QUARTER SECTION CALLS - SECTION - TOWNSHIP - RANGE

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

COUNTY WHERE PROJECT IS LOCATED. (PROJECT SHOULD ALREADY BE OPERATING)

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

PROJECT OCC ORDER NUMBER AND DATE THE PROJECT STARTED

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

TYPE OF ENHANCE RECOVERY PROJECT - SECONDARY RECOVERY - TERTIARY RECOVERY

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

PROJECT BEGINNING DATE (INJECTION DATE)

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

PRIMARY INJECTANT

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

BASE PRODUCTION AMOUNT

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

DECLINE RATE

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

APPLICANT’S SIGNATURE BLOCK

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

INSTRUCTIONS - INCLUDE A PLAT OF THE ENHANCED RECOVERY PROJECT - A PRODUCTION HISTORY - CALCULATION OF THE BASE PRODUCTION AMOUNT - ITEMIZED LIST OF CAPITAL COSTS

FORM 1139 – APPLICATION FOR ENHANCED RECOVERY PROJECT/GROSS PRODUCTION TAX EXEMPTION

OCC USE ONLY – DO NOT WRITE BELOW THIS LINE