Form Der-1 - Montana Disregarded Entity Information Return - 2003
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1
2MONTANA
2003 Montana Disregarded
DER-1
Rev. 10-03
Entity Information Return
For calendar year 2003 or tax year beginning_____________, 2003; ending_____________, 20_____
Name
Check box if this is
Check if
a change of address.
FEIN or SSN:
Applicable:
____Initial Return
Address
____Final Return
Multistate
City
State
Zip + 4
____Entity
Are you filing the forms below with your Montana Disregarded Entity Return, DER-1?
Yes
No
Form PT-CR1 Montana Composite Income Tax Return
Form PT-NRA Montana Nonresident Income Tax Agreement
Form PT-WH Nonresident Individual Withholding
1. Ordinary income (loss) from trade or business activities (Form 1120S, page 1, line 21)
1.
Assumed business name registered with
2. Net income (loss) from rental real estate activities
2.
Montana Secretary of State:_____________________________________________________________
3. a. Gross income from other rental activities
3a.
Date registered with the Montana Secretary of State:__________________________________________
b.
Expenses from other rental activities (attach schedule)
3b.
Net income (loss) from other rental activities (subtract line 3b from line 3a)
3.
State or country where incorporated or formed:______________________________________________
4. Portfolio income (loss):
a.
Interest income
4a.
Date incorporated or formed:____________________________________________________________
b.
Dividend income
4b.
c.
Royalty income
4c.
d.
Net short-term capital gain/(loss) (attach Federal Schedule D)
4d.
Disregarded Entity Type (Check appropriate entity type)
e.
Net long-term capital gain/(loss) (attach Federal Schedule D)
4e.
f.
Other portfolio income (loss)
4f.
Single Member Limited Liability Company
Total portfolio income
4.
Note: If the sole member of a single limited liability company is an individual who has been a
5. Net gain (loss) under section 1231 (other than due to casualty or theft) (attach Form 4797)
5.
full-year Montana resident during the applicable reporting period, it is not necessary to file
6. Other income (loss)
6.
Form DER-1.
7. Total lines 1 through 6
7.
8. Charitable contributions (attach schedule)
8.
IRC § 761 Partnership
9. Section 179 expense deduction (attach Form 4562)
9.
Date of IRC § 761 election:_________________________________________________
10.
Deductions related to portfolio income/(loss) (you must itemize)
10.
Internal Revenue Service Center where the election is filed._______________________
11.
Other deductions (attach schedule)
11.
IRC § 1361(b)(3) Qualified Subchapter S Subsidiary
12.
Total lines 8 through 11
12.
Date of IRC 1361(b)(3) election:_____________________________________________
13.
Add:
a. Interest and dividends not taxable under the Internal
13a.
Internal Revenue Service Center where the election is filed:_______________________
Revenue Code (non-Montana).
b. Taxes based on income or profits
13b.
IRC § 856(i)(2) Real Estate Investment Trust (Qualified REIT Subsidiary)
c. Other additions (attach detailed breakdown)
13c.
Total Montana additions to income
13.
IRC § 860D Real Estate Mortgage Investment Conduit (REMIC). Attach a copy of Federal
14.
Subtract:
a. Interest on U.S. Government Obligations (attach schedule) . .
14a.
Form 1066.
b. Deduction for purchasing recycled material (attach Form RCYL)
14b.
c. Other deductions (attach detailed breakdown)
14c.
Payments
Total Montana deductions to income
14.
15.
Disregarded Entity late file penalty (see instructions)……………………………….____________
15.
Income taxable to shareholders (line 7 - line 12 + line 13 - line 14)
16.
16.
Multistate taxpayers: line 15 X ____________% from Schedule K, line 5
17.
Multistate taxpayers: Income allocated directly to Montana
17.
Payments
164
18.
18.
S. corporation late file penalty (see instructions)
Check here, if you do not need the Montana Small Business Corporation Information Return and Instructions sent to you next year.
A copy of your Federal Form 1120S and Schedule K-1’s must be attached
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