MONTANA
TDD
Rev. 2-07
Telecommunications (TDD) Service Fee
53-19-101, MCA
Return and Instructions
Line 7:
Enter total number of total, exempt, and taxable telephone access lines for each month.
Line 8:
Multiply line 7 (total number of taxable access lines, column c) by $0.10.
Line 9:
Administrative allowance. Multiply line 8 by 0.75% (0.0075).
Line 10: Enter previously remitted fees found to be worthless and deducted as bad debt for federal income
tax purposes.
Line 11: Enter recapture of fees collected and previously written off as bad debts.
Line 12: Enter total amount due. (sum of lines 8, 9, 10 and 11).
Line 13: Enter amount paid with this return. This should equal line 12.
Make check payable to the Department of Revenue. Mail this return and payment to:
Department of Revenue, PO Box 5835, Helena, MT 59604-5835
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Cut on this line
Montana Department of Revenue
Above space is for department use only
Telecommunications Service Fee (TDD)
1. F EIN
2. Account ID
Column a.
Column b.
Column c.
7. Total access lines
Total
Exempt
Taxable
3. Q uarter Ending:
4.
If this is an amended return,
Access Lines
Access Lines Access Lines
Due:
check here
First month of quarter .........
5. I f you are no longer in business and want your account
cancelled, enter the final date
Second month of quarter ....
6. I f your mailing address has changed, check the box and
Third month of quarter ........
print new address below:
Total access lines ...............
8. Fee computation
(total of column c, times $0.10)
$
Signature
9. Administrative allowance (0.75%).
$ (
)
Title
Phone
Date
10. Uncollectible fees
$ (
)
11. Uncollectible fees recaptured
$
Name ___________________________________________
12. Total fees due
Address _ _________________________________________
(sum of lines 8, 9, 10 and 11)
$
Address _ _________________________________________
13. Enter amount paid
cents
with this return
City, State Zip _____________________________________
,
.
,