Form Der-1 - 2008 Montana Disregarded Entity Information Return Page 2

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Schedule I
Disregarded entity name ____________________________ Tax period ending ____________________________________ SSN/FEIN ___________________
Disregarded Entity Owner Information
Enter the total number of owners _____
Complete columns E through G for a nonresident individual, foreign C corporation or second tier pass-through entity owner
Nonresident individual, foreign C corporation and
All Owners
second tier pass-through entity owner information
A
B
C
D
E
F
G
Name and address of owner
Montana corporation
Montana individual
Consent
Ownership
Montana source
tax withheld. Multiply
tax withheld. Multiply
agreement
Name
Identifi cation Number
%
income
column D by 6.75%
column D by 6.9%
or statement
Street Address
and enter result.
and enter result.
(year)
City | State | Zip Code
1.
SSN
FEIN
2.
SSN
FEIN
3.
SSN
FEIN
4.
SSN
FEIN
5.
SSN
FEIN
6.
SSN
FEIN
7.
SSN
FEIN
Column Totals
Use additional sheets if necessary or you may use a document formatted similarly to Schedule I as a substitute.

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