Form Der-1 - 2008 Montana Disregarded Entity Information Return

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MONTANA

DER-1

Clear Form

Rev. 10-08

2008 Montana Disregarded Entity Information Return

For calendar year 2008 or tax year beginning (MM-DD) ___ - ___- 08 and ending (MM-DD-YY) ___ - ___ - ___

Check if

Name of the disregarded entity

FEIN or SSN:

Applicable:

__________________

____Initial Return

Check this box if this

Address

Check this box if this is a change of address.

____Final Return

FEIN or SSN is the

same as the owner’s

____Amended

FEIN or SSN.

City

State

Zip + 4

1. Enter your disregarded entity’s business name if different from above __________________________________

2. Enter the date that you incorporated or formed your disregarded entity __________________________________

3. Enter the date that you registered your disregarded entity with the Montana Secretary of State _______________

4. Enter the state or country where you incorporated or formed your disregarded entity _______________________

5. Disregarded Entity Type (Check appropriate entity type)

Single Member Limited Liability Company

You do not have to complete Montana Form DER-1 if your single member limited liability company is owned by a

full-year Montana resident during the applicable reporting period.

Check only one single member limited liability company owner type.

C corporation

Individual, Estate, or Non-Grantor Trust

S corporation

Partnership

Qualiﬁ ed Subchapter S Subsidiary

Real Estate Mortgage Investment Conduit (REMIC)

Real Estate Investment Trust (REIT)

Electing IRC § 761 Partnership

Qualiﬁ ed REIT Subsidiary

Any other single member not described above

IRC § 761 Partnership ..........................................................Enter date of election: ________________________

IRC § 1361(b)(3) Qualiﬁ ed Subchapter S Subsidiary ...........Enter date of election: ________________________

IRC § 856(i)(2) Qualiﬁ ed Real Estate Investment Trust Subsidiary

IRC § 860D Real Estate Mortgage Investment Conduit (REMIC). Attach a copy of federal Form 1066.

Late File Penalty

6. Late ﬁ le penalty (see instructions) .................................................................................................... 6. _____________

Disregarded Entity Backup Withholding Payment from Schedule I (Enter the tax withheld for the owners.)

7. Enter the total from Schedule I, Column E ....................................................................................... 7. _____________

8. Enter the total from Schedule I, Column F ........................................................................................ 8. _____________

9. Add lines 7 and 8, then enter the result. This is your total disregarded entity backup

withholding. ...................................................................................................................................... 9. _____________

10. Add lines 6 and 9, then enter the result. This is your total payment due. ................................... 10. _____________

Declaration

I, the undersigned, declare that I am authorized to sign the disregarded entity return and that the return, including all

accompanying attachments, is, to the best of my knowledge and belief, true, correct and complete.

________________________________________________________________________________________________

Signature

Title

Telephone Number

Date

164