Each check stub, attachment to a payment form, or other remittance advice must include:
(1) the lease, property, or well name, any lease, property, or well identification number used to identify the lease, property, or well, and a county and state in which the lease, property, or well is located;
(2) the month and year during which the sales occurred for which payment is being made;
(3) the total number of barrels of oil or the total amount of gas sold;
(4) the price per barrel or per MCF of oil or gas sold;
(5) the total amount of state severance and other production taxes paid;
(6) the windfall profit tax paid on the owner's interest;
(7) any other deductions or adjustments;
(8) the net value of total sales after deductions;
(9) the owner's interest in sales from the lease, property, or well expressed as a decimal;
(10) the owner's share of the total value of sales before any tax deductions;
(11) the owner's share of the sales value less deductions; and
(12) an address and telephone number at which additional information regarding the payment may be obtained and questions may be answered.