MONTANA
ATL
Clear Form
Rev. 11-07
Assumption of Tax Liability
1. Name of corporation wishing to have tax liability assumed in the State of Montana:
_____________________________________________________________________
Organized under the laws of the State of _____________________________________
Federal Employer Identifi cation Number: __________________
2. Name of corporation assuming tax liability for the above (must be fi ling a Montana return):
_____________________________________________________________________
Organized under the laws of the State of _____________________________________
Federal Employer Identifi cation Number: __________________
I, undersigned offi cer of the corporation, (2. above), hereby unconditionally agree to fi le or
cause to be fi led with the Montana Department of Revenue, such returns and data that may
be required of the corporation (1. above). In addition, I agree to pay or cause to be paid, in
full, all accrued or accruing liabilities for tax, penalty and/or interest of the corporation (1.
above) to the Montana Department of Revenue pursuant to the laws and rules of the State
of Montana.
________________________________________
_________________________
Signature of Offi cer
Date
________________________________________
_________________________
Title
Telephone Number
Mail to:
Montana Department of Revenue
PO Box 8021
Helena, MT 59604-8021
200