PDF document
- 1 -
                                                    Reset Form                                                         SV 3A
                                                                                                                       Prescribed 9/10
                  P.O. Box 530
                  Columbus, OH 43216-0530

                  Oil and Natural Gas Regulatory Cost Recovery Schedule
Name         Account No.

Street         Period

City State ZIP code
There is an oil and natural gas regulatory cost recovery fee imposed on each owner of a well. The owner is responsible for paying the 
fee unless such owner designates a severer to pay the amount on the owner’s behalf. The oil and natural gas regulatory cost recovery 
fee is not a tax. 
If you own either an oil well or a natural gas well or both, you must complete this schedule. The only exception to the fi ling requirement 
is an exempt domestic well.
If as an owner you are not required to fi le the severance tax return (SV 3), you are still required to fi le this form.

                                                                          A              B                            C
  1.  Severance tax (sum of lines 7 and 8 from 
                                                                                                           $
      severance tax return, SV 3) 

   2. Oil calculation (barrels extracted multiplied                       bbl x $.10
                                                                                      $
  by $.10)                                                                             

   3. Natural gas (mcf extracted multiplied by                            mcf x $.005 $
  $.005)                                                                               
   4. Total oil and natural gas (add lines 2 and 3, 
  Column B)                                                                                                $                0

   5. Severance tax plus total oil and natural gas
      (line 1 plus line 4)                                                                                 $                0

   6. Total number of wells multiplied by $15                             wells x $15                      $

   7. Subtotal (greater of line 5 or line 6)                                                               $

   8. Oil and gas regulatory cost recovery fee 
      (line 7 minus line 1)                                                                                $

   9. Interest on late payment (see instructions)                                                          $

  10. Total amount due (line 8 plus line 9)                                                                $                0

                                                    Defi nitions
“Severer” means any person who actually removes the natural                 well or obtain a permit under this chapter for a well or if the entire 
resources from the soil or water in this state.                             interest of a well is transferred to the person in accordance with 
                                                                            Ohio Revised Code section 1509.31(B).
“Owner,” unless referring to a mine, means the person who has 
the right to drill on a tract or drilling unit, to drill into and produce   If you do fi le a severance tax return (SV 3), please submit this 
from a pool, and to appropriate the oil or gas produced therefrom           schedule with your severance tax return.  
either for the person or for others, except that a person ceases to 
be an owner with respect to a well when the well has been plugged           I declare under penalties of perjury that this return, including any 
in accordance with applicable rules adopted and orders issued un-           accompanying schedules and statements, has been examined by 
der this chapter. “Owner” does not include a person who obtains a           me and, to the best of my knowledge and belief, is a true, correct 
lease of the mineral rights for oil and gas on a parcel of land if the      and complete return and report.
person does not attempt to produce or produce oil or gas from a 

Signature Date



- 2 -
                                                                                                                     SV 3A
                                                                                                                     Prescribed 9/10
                                              Instructions                                                           Page 2

Exempt Domestic Well (prior to July 1, 2010):                             Line 9  –  If your liability is not paid on or before the due date, you 
Ohio Revised Code section 5749.03 provides that natural resources              are subject to interest from the date the schedule was 
used on the land from which removed by the severer as a part of                due until the date the schedule was actually received 
the improvement or for use in his homestead are exempt from the                by the Ohio Department of Taxation. The interest rate 
severance tax and the cost recovery fee up to yearly cumulative                is determined on a calendar year basis and can change 
market value of $1,000.                                                        from year to year. Please refer to our Web site at tax.
                                                                               ohio.gov for the current interest rate. An example of an 
Exempt Domestic Well (after July 1, 2010):                                     interest calculation is as follows:
If you obtain a well that becomes an exempt domestic well on and 
after July 1, 2010, the oil and gas regulatory cost recovery fee shall     Amount due: $5,000
be $60 to be paid to the Ohio Department of Natural Resources,             Schedule due: 2/15/10
Division of Mineral Resources Management on the fi rst day of July          Schedule fi led:  4/6/10
of each year. If you fall into this category, please contact the Division  Days late: 50
of Mineral Resources Management.                                               Interest rate: 4% (rate for year 2010)
Line 1  –  Add together the amounts in line 7, Column 4 and line 8,            50 days
                                                                                            X  4%  X  $5,000  =  $27.40 interest
Column 4 on your severance tax return (SV 3) and enter                         365 days 
the total on line 1.
                                                                          Line 10 –  Add together the amounts in lines 8 and 9, Column C. 
Line 2  – Enter the number of barrels of oil extracted in Column A             This is the total amount you owe. If you fi le a severance 
and multiply it by $.10. Enter the amount in Column B of                       tax return (SV 3), enter this amount on line 14 of the SV 
line 2.                                                                        3.
Line 3  –  Enter the mcf of natural gas extracted in Column A and         If you do not fi le a severance tax return, make remittance in the 
multiply it by $.005. Enter the amount in Column B of line                amount payable on line 10 to the Ohio Treasurer of State and mail 
3.                                                                        the cost recovery schedule and payment to Ohio Department of 
                                                                          Taxation, Excise Tax Section, P.O. Box 530, Columbus, OH 43216-
Line 4  –  Add line 2 and line 3, Column B. Enter the total in Column 
                                                                          0530.
C of line 4.
                                                                          Penalty Provision: Any person who fails to fi le a cost recovery 
Line 5  – Add line 1 and line 4. Enter amount in Column C of line 
                                                                          schedule or pay the cost recovery fee as required may be subject 
5.
                                                                          to an assessment that includes a penalty of fi ve (5) percent per 
Line 6  –  Enter the number of wells subject to the fee in Column A       month of the amount of the unpaid fee due, to a maximum penalty 
and multiply the number of wells by $15. Enter the total                  of twenty-fi ve (25) percent.
in Column C of line 6.
                                                                          If you have any questions, please call the Excise Tax Section at 
Line 7  –  Enter the greater of line 5 or line 6 in Column C of line      (855) 466-3921.
7.
Line 8  –  Subtract line 1 from line 7. This is your oil and natural gas 
regulatory cost recovery fee amount.  






PDF file checksum: 2196724534

(Plugin #1/8.13/12.0)