Public Service Regulation Tax Form - Montana Department Of Revenue

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Rev. 03-07
Public Service Regulation Tax
69-1-402, MCA
Return and Instructions
Tax rate effective for October 1, 2006 thru September 30, 2007
Line 7:
Enter total revenue generated by all regulated activiies within Montana
Line 8:
Enter total revenue generated from sales to other regulated companies for resale.
Line 9:
Subtract line 8 from line 7.
Line 10:
Multiply line 9 by rate.
Lines 11 & 12:
If payment is delinquent you are subject to penalty and interest. A penalty of 10% on unpaid taxes is
assessed on late payments. Interst on late tax payments must bear interest until paid at a rate of 1% a
month or fraction of a month, computed from the original due date of the return.
Line 13:
Enter total amount paid with return (sum of lines 10, 11 and 12).
Line 14:
Enter amount paid with this return. This should equal line 13.
Make check payable to the Department of Revenue. Mail this return and payment to:
Department of Revenue, PO Box 5835, Helena, MT 59604-5835
--------------------------------------------------------------------------------- Cut on this line ---------------------------------------------------------------------------------
Montana Department of Revenue
Public Service Regulation Tax (PSR)
1. F EIN
2. A ccount ID
Above space is for department use only
7. Gross operating revenue generated by
3. P eriod:
4. I f this is an amended return,
all regulated activities within Montana.
check here
5. I f you are no longer in business and want your account
8. Gross revenues from sales to other
cancelled, enter the final date ______________________
regulated companies for resale.
$ (
6. I f your mailing address has changed, check the box and
print new address below:
9. Total - subtract line 8 from line 7.
_ _____________________________________________
1 0. Tax due (line 9 times tax rate of 0.0022). $
_ _____________________________________________
1 1. Penalty
1 2. Interest
1 3. Total amount due
(sum of lines 10, 11, and 12)
Name ____________________________________________
1 4. Enter amount paid
Address __________________________________________
with this return
Address __________________________________________
City, State Zip _____________________________________


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