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DR 0021PD (07/30/19)
COLORADO DEPARTMENT OF REVENUE
Denver CO 80261-0006
*DO=NOT=SEND* www.Colorado.gov/Tax
Instructions For Preparing Severance
Tax Schedule Form DR 0021PD
The DR 0021PD is an informational schedule (G) MCF Gas Gross. Enter in column (G) your share
required by the Department of Revenue to document the of gross natural gas, coalbed methane, and carbon
gross income and deductions from properties where the dioxide produced in thousand cubic feet.
taxpayer is the producer and/or operator; and any take-in- (H) MCF Gas Stripper Gas Production. Enter in
kind income. This form details the transportation, processing column (H) that part of the gross MCF gas that is
and manufacturing costs deducted from gross income.
from a qualified Colorado stripper gas well. The
Column gas production from any well that produces 90,000
(A) Source of Income. Enter in column (A) the well, cubic feet or less of gas per day for the average of
tract, lease or field name that identifies the revenue all producing days in your tax year is exempt from
source. All well operators must list income on a severance tax. (Records to prove the production on a
well-by-well basis. If you are filing from information single stripper-well basis are necessary to establish
on withholding DR 0021W, enter the name of the your right to this exemption.)
payor. When claiming a stripper well exemption for (I) Transportation. Enter in column (I) the amount of
production from a particular well, you must record transportation costs the taxpayer is claiming as a
each well on one line, or provide detail on a well deduction from gross income.
basis with the return. In other cases the well, tract,
(J) Processing and Manufacturing. Enter in column (J)
lease or field identifier may be used as you desire.
the amount of processing and manufacturing costs
If gross income includes any take-in-kind income,
the taxpayer is claiming as a deduction from gross
please list separately on a well-by-well basis.
income.
(B) API Number. Enter in column (B) the American
(K) Ad Valorem Tax. Round all amounts to whole dollars.
Petroleum Institute (API) well number of the income Based on your accounting method (cash or accrual
source. basis), enter in column (K) your share of ad valorem tax
(C) Type of Ownership. Indicate in column (C) whether paid or accrued to Colorado local governments in the
your ownership is a royalty interest (RI), working taxable year on oil and gas production. Do not include
interest (WI), or any take-in-kind (TIK). ad valorem tax on buildings, improvements, or
(D) Percentage of Ownership. Enter in column (D) your equipment. A percentage of ad valorem tax is allowed
percentage of ownership. as a reduction to the severance tax.
Production. If you are a producer or own a working (L) Gross Income. Round all amounts to whole dollars.
interest, or claim stripper well exemptions, enter: Based on your accounting method of cash or
accrual basis, enter in column (L) your share of the
(E) Barrels of Oil Gross. Enter in column (E) your share
gross income received or accrued on oil or gas
of gross barrels of oil produced. Include both taxable
production. Report the gross amount of oil shale
and exempt production.
royalties before any deductions.
(F) Barrels of Oil Stripper Oil Exemption. Enter in
column (F) that part of the gross barrels of oil that
is from a qualified Colorado stripper oil well. The oil
production from any well that produces 15 barrels
or less of crude oil per day for the average of all
producing days in your tax year is exempt from
severance tax. (Records to prove the production on
a single stripper well basis are necessary to establish
your right to this exemption.)
