Form Rtet - Retail Telecommunication Excise Tax

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MONTANA
RTET
Rev. 5-04
Retail Telecommunication Excise Tax
15-53-130, MCA
This form must be completed in its entirety.
Report for the quarter ending _____________________, 20___
(Due sixty days after the quarter end)
I. Telecommunication Provider Information
b.
Federal Identification Number
a. Provider name and address
_________-______________
c.
Request to file on accrual and electronic basis
(see instructions)
d.
Is this a final return? ___Yes ___No
If yes, attach an explanation and date of
sale or merger or close if business.
II. Tax Computation
Total Gross
Exclusions
Wholesale
Retail
1. Revenue attributable to Montana
telecommunication services:
(see instructions on back side)
a. Wireless
b. Long distance
Local exchange
c.
Other
d.
Total
2. Multiply total retail by .0375 (3.75% tax)
(total retail = sum of a, b, c, and d)
3. Less credits: Excise tax paid on worthless accounts
(
)
4. Adjustment to previous quarters (attach explanation)
5. Penalty and interest (see instructions)
6. Total paid with this return (sum of lines 2, 3, 4 and 5)
7. Internet access revenue (see instructions for line 7)
Revenue Account Code 512043
___________________________________________________________Date_____________Phone______________(Ext.)_______
Signature of Principal/Agent/Preparer
332

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