Oil, Gas, or Other Mineral Rights Lease

Report leased oil, gas, or other mineral rights and income from the lease in Part 6.





Income Type

Income Amount


Oil lease, Fargo, ND – Humble Oil and Refining Co.


$1,001 - $15,000

rent or royalties

$201 - $1,000


Natural gas lease, Dallas, TX –      El Paso Corporation


$50,001 - $100,000

signing bonus


For You, Your Spouse, and Your Dependent Children

Part 6

Report a lease if the value of the lease was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

DescriptionIndicate that the asset is a lease and provide: (1) the location of the land (either city and state or county and state); (2) the resource being extracted under the terms of the lease; and (3) the name of the lessee (i.e., company extracting resources and paying royalties).

EIFSelect “N/A.”

ValueReport the value of the lease by selecting the appropriate category.

Income Type:  Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.  Leases normally produce “rent or royalties” income, but in some cases they may also produce dividends, interest, or capital gains.  If the lease produces any other type of income, provide an appropriate description (e.g., “signing bonus” or “upfront payment”).

Income Amount:

(1) Income less than $201:  Select the category for “None (or less than $201).”

(2) Dividends, capital gains, interest, rent, or royalties:  Select the category that corresponds to the total amount of income received during the reporting period.

(3) Other income:  Provide the exact amount of income received during the reporting period.

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