Form Tc-1 - Retail Communication Excise Tax Registration Form April 2004
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1MONTANA
Form TC-1
Rev. 4/04
MONTANA
Department of Revenue
Retail Communication Excise Tax
Registration Form
Federal ID Number:
First Day of Business in Montana:
Legal Name:
DBA Name:
Mailing Address:
Type of Telephone Business (check all that are applicable):
Local Exchange Company
Cellular Company
Enhanced Paging Service
Long Distance Company
Cellular Reseller
Broadband PCS
Long Distance Reseller
Pay Phone Company
Narrowband PCS
Bulletin Board
Competitive Access Provide
Operator Service Provider
Mobile Telephone Company
Radio Common Carrier
Other (please explain)
Market areas you will be filing for:
Person responsible for filing Telephone License Tax
Telephone Number
Signature of Principal or Agent
Date
Phone Number
Please complete and return to: Department of Revenue, Attn: Retail Communication Excise Tax,
PO Box 5835, Helena, MT 59604-5835
335
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Parent category: Financial