Form Uch - Montana Unclaimed Property Holder Payment Voucher 2015
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1Montana Unclaimed Property Holder Payment Instructions
e-Pay
Available at revenue.mt.gov under Online Services
ACH Credit
You can use your online banking service to send payments
● submit a one-time registration to the Department of Revenue
● begin sending payments
Pay by check
Voucher Instructions
Check Instructions
Enter the business name, mailing address, full name of
Make your check payable to Montana Department of
contact and phone number.
Revenue.
Box 1 – FEIN
On the memo line of your check, note your FEIN or Account
Please enter your full Federal Employer Identification
ID and the period ending date to which the payment
Number.
applies.
Box 2 – Period Ending Date
Do not staple or tape the voucher and check together.
● Life insurance companies report year is ending
If you are paying for multiple tax periods, please provide a
December 31 with year matching the report.
voucher for each tax period and indicate the amount you
● All other holders report end date is June 30 with year
wish to be applied to that period.
matching the report.
Detach the voucher below and mail with your
Note: Please check one box in lower lefthand corner to
payment to:
indicate holder type and payment due date.
Montana Department of Revenue
Box 3 – Montana Account ID
PO Box 5805
If you have a 13 digit account ID that has been
Helena, MT 59604-5805
assigned to you by the Montana Department of
If you have questions, please call us toll free at
Revenue, please enter it.
(866) 859-2254 (in Helena, 444-6900). We are available
If you do not have a 13 digit account ID, leave the field
Monday through Friday, 8 a.m. to 5 p.m.
blank.
Box 4 – Amount Paid
Enter the amount you are remitting, including the cents.
Do not include dollar signs, commas or decimals.
CLEAR FORM
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Cut line
Form UCH
Montana Unclaimed Property
Please use this voucher and include your full FEIN
to ensure proper credit of your payment. Payments
Holder Payment Voucher
Rev 04 15
in the amount of $500,000 or more must be made
electronically.
Name ______________________________________
1. FEIN
Mailing Address _____________________________
City, State, Zip ______________________________
M M D D Y Y Y
2. Period Ending Date
Contact ____________________________________
3. Montana
U C H
Phone Number ______________________________
Account ID
.
Life Insurance Company Holder
Payment due May 1.
4. Amount Paid
Non-Life Insurance Company Holder
Payment due November 1.
Pay online at revenue.mt.gov
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Parent category: Financial