Form Clt-4x - Amended Montana Corporation License Tax Return printable pdf download

MONTANA

CLT-4X

Rev. 8-03

Amended Montana Corporation License Tax Return

For calendar year ____________ or other taxable year beginning _____________, and ending ___________

Name ________________________________________________________ FEIN _____________________

Number and Street or P.O. Box _______________________________________ If new address check here

City or Town, State, and Zip Code _____________________________________________________________

Important: Please read specific instructions pertaining to refunds on back of this form.

b. Net changes

c. Correct amount

a. As originally reported

increase or decrease

or as adjusted

1. Montana taxable income ..............................................

Tax Liability

2. Tax liability - 6.75% of line 1, but not less than $50 ......

3. Surtax (see back of this form) .....................................

4. Less allowable tax credits* ..........................................

5. Adjusted tax liability......................................................

6. Less total tax paid (original plus subsequent payments) ........................................................

7. Plus previous refunds issued .................................................................................................

8. Tax due (overpayment) ...........................................................................................................

9. Add interest (see rules on back) .............................................................................................

10. Total due or (overpayment due) (total of lines 9 and 10) .........................................................

*attach a schedule if credit is different from the amount originally reported

Please check or indicate reasons for amending return:

___ NOL carryback/carryforward; year of loss __________________

___ Federal Revenue Agent Report - a complete copy of this report is required

___ Factor changes - complete back of this form, a detailed explanation of changes to factors is required.

___ Amended Federal Return (Form 1120X) - a copy of the complete 1120X is required.

___ Other - Explain in detail on the back of this form

For changes to credits attach applicable schedules and the reason for the change.

Declaration

I, the undersigned officer of the corporation for which this return is made, hereby declares that this return,

including all accompanying schedules and statements is, to the best of my knowledge and belief, a true, correct,

and complete return, made in good faith for the income period stated, pursuant to the Montana Corporation

License Tax laws and regulations.

Signature of officer is required _____________________________________________ Date _____________

Title ____________________________________________________________________________________

Address and zip code ______________________________________________________________________

Telephone no. ____________________________________________________________________________

Name of person or firm preparing return ______________________________________ Date _____________

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Form Clt-4x - Amended Montana Corporation License Tax Return