3. S1 Form ALASKA DNR - OIL & GAS V 1.20120723 REPORT TYPE S1 P REPORT CODE FILING TYPE CUSTOMER ID NUMBER REVISION NO. REPORT CONTROL NUMBER AUTHORIZED DATE PAYMENT METHOD PAYMENT SETTLEMENT DATE AMOUNT ELECTRONICALLY TRANSFERRED BANK NAME BANK LOCATION LESSEE NAME ADDRESS1 ADDRESS2 CITY STATE ZIP PREPARER PREPARER PHONE NUMBER PREPARER FAX NUMBER AUTHORIZED SIGNATURE (CODE) AUTHORIZED SIGNATURE (Printed Name) PHONE NUMBER FAX NUMBER ACCOUNTING REPORT ALLOCATION LEASE/CID PAYMENT LINE NO. PAYMENT UNIT CODE CODE CODE NUMBER DATE
3. S1 Form ALASKA DNR - OIL & GAS V 1.20120723 REPORT TYPE S1 REPORT CODE P FILING TYPE CUSTOMER ID NUMBER REVISION NO. REPORT CONTROL NUMBER AUTHORIZED DATE PAYMENT METHOD PAYMENT SETTLEMENT DATE AMOUNT ELECTRONICALLY TRANSFERRED BANK NAME BANK LOCATION LESSEE NAME ADDRESS1 ADDRESS2 CITY STATE ZIP PREPARER PREPARER PHONE NUMBER PREPARER FAX NUMBER AUTHORIZED SIGNATURE (CODE) AUTHORIZED SIGNATURE (Printed Name) PHONE NUMBER FAX NUMBER LINE NO. ACCOUNTING UNIT CODE REPORT CODE ALLOCATION CODE LEASE/CID NUMBER PAYMENT DATE PAYMENT
Reporting_Sect_II_F_S1_201401web.docx