Form Der-1 - Montana Disregarded Entity Information Return - 2003 Page 2
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1
2This form must be completed
.
Form DER-1
Montana Disregarded Entity Owner Information
FEIN or SSN____________________
a.
b.
c.
Names and addresses of owner(s),
SSN or FEIN
Ownership%
Total Montana source income,
gain, loss, deduction or credit.
%
%
%
%
%
%
%
%
%
%
%
%
If there are more than 12 names, photocopy and attach additional pages as needed. A computer printout in the same
format is acceptable.
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Parent category: Financial