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Enter your data separately for each tax lot (purchase date):
1. Account or Owner Name (optional)
2. Name of Oil or Gas Royalty Trust (optional)
3. Date of purchase (tax lot) (mm/dd/yyyy)
4. Date or tax year of royalty distribution payment (mm/dd/yyyy)
5. Number of shares or units (no commas)
6. Original total purchase cost of this tax lot including commissions & fees $ (no commas)
7. Cumulative prior depletion deductions for this tax lot $ (no commas)
8. Gross amount of royalty income from this trust before expenses $ (no commas)
9. Net amount of royalty income from this trust after all expenses except depletion $ (no commas)
10. Depletion deductions disallowed in prior years and carried over to this year $ (no commas)
11. Cost depletion for this year from information provided by trust sponsor $ (no commas)
12. Taxable income for this tax year from all sources before depletion, net operating loss carrybacks, capital loss carrybacks, or domestic production activities deductions $ (no commas)