Oklahoma Information Return - Production Payments

Information Return - Production Payments
Form 500-A Production Payments Information Return
State of Oklahoma: Production Payments

LY LLY
N
S O NICA
E
OS TRO
P
Other - please specify
Royalty
Lease Bonus
Delay Rental
Working
Lease
URInterest
EC
L
P
L DE
A
N ILE Number
Payor’s Federal Identification Number
Recipient’s
IO Identification
State Code:
T
A BE F
M
R ST
State Withholding:
O
F
Please print or type the recipient’s name, address,
and
ZIPUin the area below:
N
I
County Code:
R 0-A M
O
F 50
Do not use this form to report salaries
M
and wages. Use optional Form W-2:
R
Internal Revenue Service.
FO
FORM

Tax Year ________

* Note: All payments with Oklahoma withholding must be reported.

Please print or type the name and address
of the payor in the box below:

Report payment of $750 or more in these five boxes (*see note):

State of Oklahoma: Production Payments

Information Return

LY LLY
N
S O NICA
E
OS TRO
P
Other - please specify
Royalty
Lease Bonus
Delay Rental
Working
Lease
URInterest
EC
L
P
AL ED E
N
IL Number
Payor’s Federal Identification Number
Recipient’s
IO Identification
F
State Code:
T
A BE
M
R ST
State Withholding:
O
F
Please print or type the recipient’s name, address,
and
ZIPUin the area below:
N
I
County Code:
R 0-A M
O
F 50
Do not use this form to report salaries
M
and wages. Use optional Form W-2:
R
O
Internal Revenue Service.
F
FORM

Tax Year ________

* Note: All payments with Oklahoma withholding must be reported.

Report payments of $10 or more
in this box (*see note):

Please print or type the name and address
of the payor in the box below:

500-A

Report payment of $750 or more in these five boxes (*see note):

State of Oklahoma: Production Payments

LY LLY
N
A
O
Tax Year ________ ES NIC
OS TRO
P
UR LEC
P
E
Other - please specify
Royalty
Lease Bonus
Delay Rental
Lease
ALWorking
D Interest
N
E
L
TIO E FI
A
Payor’s Federal Identification Number
RM Recipient’s
State Code:
T B Identification Number
O
S
F
U
IN M
State Withholding:
A ZIP in the area below:
R
-and
Please print or type the recipient’s name,
address,
O
0
F 50
County Code:
M
R
Do not use this form to report salaries
FO
and wages. Use optional Form W-2:
FORM

Information Return

* Note: All payments with Oklahoma withholding must be reported.

Report payments of $10 or more
in this box (*see note):

Revised 2021

Report payments of $10 or more
in this box (*see note):

500-A

Revised 2021

Information Return

500-A

Report payment of $750 or more in these five boxes (*see note):

Internal Revenue Service.

Revised 2021

Please print or type the name and address
of the payor in the box below: