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2009 Montana Corporation License Tax Return
Clear Form
Form CLT-4
Attach a copy of federal Form 1120 as fi led with the Internal Revenue Service
For calendar year 2009 or tax year beginning (MM-DD) ___ - ___- 09 and ending (MM-DD-YY) ___ - ___ - ___
Corporation Name
FEIN: _________________
Check if
applicable:
Federal Business Code:
Initial
______________________
Return
Mailing Address
If new address, check here
Incorporated in
Final
State of: _______________
Return
Date: _________________
Amended
Return
City
State
Zip+4
Date Qualifi ed
in Montana: ____________
Refund
Return
Check this box if you do not need the Montana corporation license tax return and instructions sent to you next year.
Part I - Filing Method.
1. Check this box if you are exempt from tax under the provision of Public Law 86-272. .......................................................
If checked, Schedule K must be completed and attached to your tax return and skip questions 2 through 5 of this part.
2. Are you a member (parent or subsidiary) of a consolidated group for federal purposes? ...........................
Yes
No
3. Are you fi ling a combined return for Montana purposes? .............................................................................
Yes
No
If “Yes,” enter the number of entities with Montana activity included in this tax return. ___________
4. If you answered “Yes” to questions 2 or 3 above, then check one of the following fi ling methods and attach Schedule M:
a. Separate Company
d. Domestic Combination
b. Separate Accounting
e. Limited Combination
c. Worldwide Combination
f. Water’s Edge
(You must have a valid election and Schedule WE must be attached.)
5. If you answered “Yes” to questions 2 or 3 above, you must attach pages 1 through 4 of the parent’s consolidated federal Form
1120 that you fi led with the Internal Revenue Service, and enter:
a. U.S. parent’s name as reported on federal tax return __________________________________________________________
b. U.S. parent’s FEIN _____________________________________________________________________________________
Part II - Amended Return Only. Check all that apply.
a. Federal Revenue Agent Report; a complete copy of this report must be attached ........................................................... a.
b. NOL carryback/carryforward; year(s) of loss _________________________
............................................................... b.
c. Apportionment factor changes; attach a statement explaining all adjustments in detail ....................................................c.
d. Amended federal tax return (Form 1120X); a complete copy of the federal Form 1120X must be attached ..................... d.
e. Application and/or change in tax credit; type of credit being claimed ____________________________ .................... e.
f. Other; attach a statement explaining all adjustments in detail ........................................................................................... f.
Part III - General Questions. All questions must be answered.
a. Describe in detail the nature and location(s) of your Montana activities (if necessary, provide the description
on an additional page). ________________________________________________________________
b. Is this your corporation’s fi rst Montana tax return? ...................................................................................................
Yes
No
If this corporation is a successor to your previously existing business, enter:
Name ______________________________________________ and FEIN _______________________
c. Is this your corporation’s fi nal Montana tax return? ..................................................................................................
Yes
No
If “Yes,” indicate whether your corporation has:
Withdrawn;
Merged (please attach detailed statement);
Dissolved (please attach detailed statement);
Reorganized (please attach detailed statement).
Date of withdrawal, dissolution, merger, or reorganization ______________________
If applicable, enter the successor’s name ___________________________________________ and FEIN __________________
d. For any tax period(s), has the Internal Revenue Service issued an offi cial notice of change or correction that
you have not fi led with the Montana Department of Revenue? ...............................................................................
Yes
No
If “Yes,” indicate what period(s) __________________________________________________________
e. Are any statute of limitation waivers currently in force that have been executed with the Internal Revenue
Service? ...................................................................................................................................................................
Yes
No
If “Yes,” which taxable year(s) is covered and what is the expiration date(s) of the waiver(s)? _________
__________________________________________________________________________________