Montana Form Cr-T - Tax Certificate Request
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1MONTANA
Tax Certificate Request
CR-T
Instructions on back
Rev. 2-06
Type of certificate requested
____Title 15
____Dissolution/Withdrawal
____Reviver
____Tax Clearance
____Good Standing
To reinstate with the
To withdraw/dissolve
To reinstate with Secretary To verify that
To show that your
Secretary of State after being
with the Secretary of State
of State after being
your final return
filing and payment
involuntarily dissolved.
suspended by DOR
was filed
requirements are current
Entity name:_______________________________________________________________________
Indicate your filing type:
C. Corporation___ S. Corporation___ LLC taxed as a partnership___ LLC taxed as a corporation___
Enter your Federal ID Number:___________________________________________________________
Enter the date that the entity was formed:___________________________________________________
Enter the state in which the entity was formed:_______________________________________________
If you file as a corporation, please complete the following:
Are you filing a combined return? yes___ no___
If yes, enter the parent’s:
Name_________________________________________________________
FEIN__________________________________________________________
Are you a nonprofit organization? yes___ no___ A corporation must qualify for tax exempt status
prior to receiving a certificate. (See instructions)
Indicate whether your entity is: Withdrawing____ Dissolving____ Merging____ Reinstating____
If merging, please provide the following for the surviving entity:
Name_________________________________________________________
FEIN__________________________________________________________
If your company is included in the Montana filing of another company, you have to file an Assumption of Tax
Liability. If you would like an Assumption of Tax Liability faxed to you, enter your fax number
here:____________________
Where would you like us to send your certificate?
Name:___________________________________________________________________
Address:_________________________________________________________________
________________________________________________________________________
Contact phone:___________________________________________________________________
Check this box if you would like the original certificate to be sent directly to the Secretary of State.
Please note: In order for the certificate to be sent directly to the Secretary of State, all necessary
paperwork has to be first filed with their office.
Signature of officer:_______________________________ Date:_______________________
Print name and title:__________________________________________________________
Send or fax this request to: Montana Department of Revenue
Montana Department of Revenue
Phone: (406) 444-6900
Attn: Certificates
Fax:
(406) 444-6642
PO Box 8021
Helena, MT 59604-8021
For Office Use Only:
207
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