Form Cr-T - Tax Certifi Cate Request
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1MONTANA
Clear Form
CR-T
Tax Certifi cate Request
Rev. 01-08
Instructions on back
Type of certifi cate requested
___ Title 15
___ Dissolution/
___ Reviver
___ Tax Clearance
___ Good Standing
To reinstate with the
Withdrawal
To reinstate with
To verify that your fi nal
To show that your
Secretary of State after
Secretary of State after
return was fi led and all
fi ling and payment
To withdraw/dissolve
being involuntarily
being suspended by the
taxes have been paid
requirements are current
with the Secretary of
dissolved
Department of Revenue
State
Entity name: ________________________________________________________________________
Indicate your business type:
___ C corporation
___ S corporation
___ LLC taxed as a partnership
___ LLC taxed as a corporation
Enter your Federal Employer Identifi cation Number: _____________________________
Enter the date that the entity was formed: _____________________________________
Enter the state in which the entity was formed: _________________________________
If you fi le as a corporation, please complete the following:
Are you fi ling a combined return? ___ Yes
___No
If yes, enter the parent’s:
Name ________________________________________________________
FEIN ___________________________
If your company is included in the Montana fi ling of another company, you must fi le an Assumption of Tax Liability.
If you would like an Assumption of Tax Liability faxed to you, enter your fax number here: _______________
Are you a nonprofi t organization?
___ Yes
___No
A corporation must qualify for tax exempt status prior to receiving a certifi cate. (See instructions)
Indicate whether your entity is: ___ Withdrawing
___Dissolving
___ Merging
___ Reinstating
If merging, please provide the following for the surviving entity:
Name ___________________________________________________________
FEIN ____________________________________________________________
Where would you like us to send your certifi cate?
Name: __________________________________________________________
Address: ________________________________________________________
________________________________________________________
Contact phone: ___________________________________________________
Check this box if you would like the certifi cate to be sent directly to the Secretary of State.
Please note: In order for the certifi cate to be sent directly to the Secretary of State, all necessary
paperwork must fi rst be fi led with that offi ce.
Signature of offi cer: __________________________________Date: _______________
Print name and title: _____________________________________________________
Mail this request to: Montana Department of Revenue, Attn: Certifi cates, PO Box 8021, Helena, MT 59604-8021.
or Fax this request to: (406) 444-6642
Questions? Please email us at DORTaxCertifi cates@mt.gov or call us at (406)444-6900.
For Offi ce Use Only:
207
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Parent category: Financial