MONTANA
Clear Form
INA-CT
Rev. 07-09
Affi davit of Corporate Inactivity
Corporation/LLC Name ________________________________________________________
Address ___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
City, State, Zip + 4 ____________________________________________________________
FEIN ______________________________________
Contact Person ______________________________
Phone _____________________________________
I, ______________________________________ , an offi cer of the said corporation,
being of lawful age, being sworn on oath, depose and say that I am acquainted with
the affairs of the said corporation existing under and by virtue of the laws of the State
of Montana; (or a corporation registered to do business in Montana) and that the said
corporation had no income or business activities of any nature in Montana during the
following periods from:_____________________to:______________________.
I understand that said corporation is required to fi le each year an Affi davit of Corporate
Inactivity or if said corporation does engage in business or have any income they will
notify the department by fi ling a Montana Corporation License Tax Return by the due
date prescribed in 15-31-111, MCA.
_______________________________________
___________________________
Signature of Corporate Offi cer
Title
Mail to:
Montana Department of Revenue
PO Box 5805
Helena, MT 59604-5805
On this _____________ day of ________________________, 20 ___
Personally appeared _______________________________________
before me a Notary Public for the State of ______________________ ;
________________________________________________________
(SEAL)
(Signature of Notary Public)
____________________________ , Residing at _________________
(Name of Notary)
(City and State)
My Commission Expires ____________________________________
(Month, Day and Four Digit Year)
212