Montana Form Rw-3 - Montana Annual Mineral Royalty Withholding Tax Reconciliation - 2009
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1
2MONTANA
Offi cial Use Only
RW-3
Reset Form
Rev. 09-07
Montana Annual Mineral Royalty Withholding Tax Reconciliation
Period End ____________________________
Offi ce Use
Only
February 28, 2009
Due Date ______________________________
FEIN/SSN _____________________________
1. Number of 1099-MISCs attached ..............
Acct ID _______________________________
2. Filing method:
Paper
Name ________________________________________
Electronic
3. Type of return:
Address ______________________________________
Original
City, State, Zip Code ____________________________
Amended
Overpayment on line 7:
4. Total Montana net royalty payments
7A. Please refund.
subject to withholding taxes .............
5. Total Montana tax withheld per
7B. Please apply to a future liability.
federal Form 1099-MISC .................
Underpayment on line 7:
Please remit your payment for additional tax
6. Withholding tax paid ........................
due with the attached voucher.
7. Difference (line 5 minus line 6) ........
Contact _________________________________________________ Telephone ________________________________
Name _________________________________ FEIN/SSN ______________________Acct ID _____________________
Annual Reconciliation of Mineral Withholding Tax
(make additional copies if necessary)
A
B
C
D
E
Quarterly Report Period
Date(s) Paid to
Montana
Tax Withheld
Tax Paid
Difference
2008
the Department
Net Royalty
of Revenue
Payments
January through March
April through June
ALL COLUMNS MUST BE COMPLETED
July through September
October through December
8. Column Totals
Please provide an explanation if there is a difference entered in column E: ______________________________________
If your mailing address has changed, check this box
and print your new address below:
____________________________________________________________
____________________________________________________________
Please send RW-3, 1099-MISCs and applicable payment to:
Montana Department of Revenue
PO Box 5835
Helena, MT 59604-5835
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