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EF-566-D-R08-0810-41000786-3
BOE-566-D (P3) REV. 08 (08-10)
INSTRUCTIONS FOR COMPLETING OIL AND DISSOLVED GAS
PRODUCTION REPORT
This report is not a public document. The information contained here will be held confidential by the Assessor (section 451,
Revenue and Taxation Code); it can be disclosed only to the district attorney, grand jury and other agencies specified in section
408 of the Revenue and Taxation Code. Attached schedules are considered to be part of the report. The Assessor’s failure to
keep such records confidential could subject him or her to civil damages (Government Code section 1504), and if such failure is
determined to be willful, the Assessor may be subjected to other sanctions as provided by law (Government Code sections 3060 - 3074).
Agents of the county hired as consultants are subject to the same provisions, sanctions and penalties upon failure to keep records
confidential.
All personal property owned by the respondent and any property belonging to others on the lease as of January 1 must be reported to the
Assessor on BOE-566-J, Oil, Gas and Geothermal Personal Property Statement.
Line numbers listed in these instructions refer to identical line numbers printed on the form. At top of form, fill in the year of lien date for
which this report is made.
LINE 1. NAME, MAILING ADDRESS AND PHONE NUMBER
a. NAME OF OPERATOR (PERSON OR CORPORATION)
If the name is preprinted, check the spelling and correct any error. In the case of an individual, enter the last name first,
then the first name and middle initial. Partnerships must enter at least two names, showing the last name, first name and
middle initial for each partner. Corporation names should be complete so they will not be confused with fictitious or DBA
(Doing Business As) names.
b. DBA OR FICTITIOUS NAME
Enter the DBA name under which you are operating in this county below the name of the sole owner, partnership, or
corporation.
c. MAILING ADDRESS
Enter the mailing address of the legal entity shown in line 1b above. This may be either a street address or a post office
box number. It may differ from the actual location of the property. Include the city, state, and zip code.
d. PHONE NUMBER
Enter the phone number where we may contact you or your authorized representative for information regarding the subject
property.
LINE 2. DESCRIPTION OF THE PROPERTY
Report each lease or parcel on a separate report form. Fill in oil field name, lease name and pool, and lease number.
Conform to Division of Oil and Gas classification in regard to name of field, lease, and pool. Check whether recovery is primary
or other type. If other, describe method, for example, waterflood, steam injection (cyclic or flood), fire flood, etc.
LINE 3. PARCEL NUMBER AND TAX RATE AREA NUMBER
Fill in the parcel number and tax rate area number, if known.
LINE 4. Submit a separate form for each Department of Energy (DOE) “Formation,” for example, Division of Oil and Gas
recognized pool, and label according to the Division of Oil and Gas nomenclature.
LINE 5. Report oil (BBLS), water (BBLS) and gas (MCF) production and steam (BBLS) or water (BBLS) injection by months on a
calendar year basis and the number of producing or injection wells and days. New wells and/or abandonments should be
reported separately.
LINE 9. List the total royalty percent. For leasehold properties check appropriate Box P or G whether the lessor is a private party or a
governmental agency and state the government royalty separately.
LINE 14. Report crude oil price per barrel at the end of December before any transportation charges.
LINE 15. Please list the posted oil field used as a reference for crude oil sales.
LINE 16. Report calendar year’s gas and gas liquids income to the property for working and royalty interests combined (excluding plant’s
share of gas and gas liquids).
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