Form Ina-Ct - Affidavit Of Inactivity
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1MONTANA
Clear Form
INA-CT
Rev. 01-11
Affi davit of Inactivity
Corporation/LLC Name _______________________________________________________________
Address
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
City, State, Zip + 4 ___________________________________________________________________
FEIN __________________________________________
Contact Person __________________________________
Phone _________________________________________
State of ___________________________________
County of __________________________________
I, _________________________________________ , being fi rst sworn on oath, depose and
say that I am an authorized representative of the designated entity, that I am acquainted with
the affairs of the entity and that the entity had no income or business activities of any nature in
Montana from:_____________________to:______________________.
I understand that each year the entity is either required to fi le an Affi davit of Inactivity or, if the
entity does engage in business or have any income, notify the department by fi ling a Montana
Corporation License Tax Return by the due date prescribed in 15-31-111, MCA.
_______________________________________
___________________________
Signature of Authorized Representative
Title
Mail to:
Montana Department of Revenue
PO Box 5805
Helena, MT 59604-5805
This affi davit was signed and sworn to before me
on __________________________________________ , 20 ______ ,
by _____________________________________________ (name) as
________________________ (title) of __________________ (entity)
Title and rank
________________________________________________________
(SEAL)
(Signature of Notarial Offi cer)
____________________________ , Residing at _________________
(Name)
(City and State)
My Commission Expires ____________________________________
(Month, Day and Four Digit Year)
2010
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