Form Der-1 - Montana Disregarded Entity Information Return - 2005
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3MONTANA
2005 Montana Disregarded
DER-1
Rev. 2-06
Entity Information Return
For calendar year 2005 or tax year beginning (MM-DD) ___ - ___- 05 and ending (MM-DD-YY) ___ - ___ - ___
Name of the disregarded entity
Check box if this is
Check if
a change of address.
FEIN or SSN:
Applicable:
Address
____Initial Return
____Final Return
Check this box if this FEIN
____Amended
or SSN is the same as the
City
State
Zip + 4
owners FEIN or SSN.
Enter your disregarded entity’s business name if different from above______________________________________
1.
Enter the date that you incorporated or formed your disregarded entity_____________________________________
2.
Enter the date that you registered your disregarded entity with the Montana Secretary of State________________
3.
1. Ordinary income (loss) from trade or business activities (Form 1120S, page 1, line 21)
1.
Enter the state or country where you incorporated or formed your disregarded entity____________________________
4.
2. Net income (loss) from rental real estate activities
2.
3. a. Gross income from other rental activities
3a.
Disregarded Entity Type (Check appropriate entity type)
5.
Expenses from other rental activities (attach schedule)
3b.
Single Member Limited Liability Company
Net income (loss) from other rental activities (subtract line 3b from line 3a)
3.
You do not have to complete Montana Form DER-1 if your single member limited liability company is owned
4. Portfolio income (loss):
by a full-year Montana resident during the applicable reporting period.
a.
Interest income
4a.
Check only one single member limited liability company owner type.
b.
Dividend income
4b.
C. corporation
Individual, Estate, or Non-Grantor Trust
c.
Royalty income
4c.
S. corporation
Partnership
d.
Net short-term capital gain/(loss) (attach Federal Schedule D)
4d.
Qualified Subchapter S. Subsidiary
Real Estate Mortgage Investment Conduit
e.
Net long-term capital gain/(loss) (attach Federal Schedule D)
4e.
Real Estate Investment Trust (REIT)
(REMIC)
f.
Other portfolio income (loss)
4f.
Qualified REIT Subsidiary
Electing IRC 761 Partnership
Total portfolio income
4.
Any other single member not described above
IRC § 761 Partnership..................................................
Enter date of election:
5. Net gain (loss) under section 1231 (other than due to casualty or theft) (attach Form 4797)
5.
IRC § 1361(b)(3) Qualified Subchapter S Subsidiary........
Enter date of election:
6. Other income (loss)
6.
IRC § 856(i)(2) Qualified Real Estate Investment Trust Subsidiary
7. Total lines 1 through 6
7.
IRC § 860D Real Estate Mortgage Investment Conduit (REMIC). Attach a copy of Federal Form 1066.
10.
8. Charitable contributions (attach schedule)
8.
Payments
11.
9. Section 179 expense deduction (attach Form 4562)
9.
12.
Deductions related to portfolio income/(loss) (you must itemize)
10.
6.
Enter your late file penalty (see instructions)....................................................................................... 6. ___________
13.
Other deductions (attach schedule)
13a.
11.
Total lines 8 through 11
12.
Disregarded Entity Backup Withholding Payment from Schedule I
Add:
a. Interest and dividends not taxable under the Internal
13b.
Enter amounts below if you withheld tax for any owners
Revenue Code (non-Montana).
13c.
Total Montana additions to income
b. Taxes based on income or profits
13.
7.
Enter the total from Column E, Schedule I ..................................................................
7.
___________
14.
c. Other additions (attach detailed breakdown)
14a.
14b.
8.
Enter the total from Column F, Schedule I ...................................................................
8.
___________
Subtract:
a. Interest on U.S. Government Obligations (attach schedule) . .
14c.
b. Deduction for purchasing recycled material (attach Form RCYL)
9.
Add line 7 and line 8, then enter the results. This your total disregarded entity backup withholding........
___________
9.
c. Other deductions (attach detailed breakdown)
15.
Income taxable to shareholders (line 7 - line 12 + line 13 - line 14)
Total Montana deductions to income
10.
Add line 6 and line 9, then enter the results. This is your total payment due.....................................
___________
10.
16.
Multistate taxpayers: line 15 X ____________% from Schedule K, line 5
14.
Multistate taxpayers: Income allocated directly to Montana
15.
17.
Declaration
16.
Payments
I, the undersigned, declare that I am authorized to sign the disregarded entity return and that the return, including all
17.
18.
S. corporation late file penalty (see instructions)
accompanying attachments, is, to the best of my knowledge and belief, true, correct and complete.
Check here, if you do not need the Montana Small Business Corporation Information Return and Instructions sent to you next year.
18.
A copy of your Federal Form 1120S and Schedule K-1’s must be attached
Signature
Title
Telephone Number
Date
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