Montana Corporation License Tax Payment Form - Montana Departmrnt Of Revenue
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Montana Corporation License Tax
(78)
Payment Instructions
Attention: Montana Department of Revenue Cashier
Complete the payment voucher below to ensure proper credit of your payment. If you are paying taxes for multiple years,
submit a separate check or money order and a separate voucher for each year. On the memo line of your check, please
note your FEIN or account ID and the tax year for which the payment applies.
Boxes 1 through 4 – Print an “X” in one box only for the type of payment you are remitting:
Check box 1, if your payment is for the current year.
Check box 2, if your payment is for estimated tax.
Check box 3, if your payment is for a tentative tax.
Check box 4, if your payment is for an amended return.
Box 5 –
Enter the tax year for which this payment applies (period ending date).
Box 6 –
Enter your federal employer identifi cation number (FEIN).
Box 7 –
Enter the amount you are remitting.
Name __________________________________________________________________
Mailing Address __________________________________________________________
__________________________________________________________
City, State, Zip Code ______________________________________________________
Phone ____________________________
Mail this form with your payment and return (if applicable) to:
Department of Revenue
PO Box 8021
Helena, MT 59604-8021
Questions? Call (406) 444-6900.
Make check or money order payable to the Department of Revenue.
Montana Corporation License Tax
Payment Form
month
day
year
1. Current year
5. Period ending
/
/
2. Estimated tax
6. Federal employer
identifi cation
number (FEIN)
3. Tentative tax
7. Amount paid
4. Amended return
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