Montana Form Ftb - First-Time Home Buyer Savings Account - 2004
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1MONTANA
FTB
Rev. 8-04
First-time Home Buyer Savings Account
Annual Reporting Information
For Self-Administered Individual Accounts
15-63-202, MCA
Instructions on back
Taxpayer Information
Name ______________________________________ Social Security Number ___________________
Account Information
First-time home buyer savings account number ____________________________________________
Financial institution where account is held ________________________________________________
Address of financial institution _________________________________________________________
_________________________________________________________
_________________________________________________________
Complete the table below for the current year. Additional information regarding first-time home buyer
savings account is provided on the back of this form. If you made withdrawals from your first-time home
buyer savings account that were not used to pay qualifying expenses, please call the department for
information at (406) 444-6900.
A
B
C
D
Date
Deposits
Interest
Withdrawals
Withdrawals
Balance
earned
used for
used for
columns A + B
eligible
noneligible
less columns
expenses
expenses
C + D
Enter beginning balance as of January 1.
Carry over amount from ending balance of prior year.
Dec. 31
Carry forward balance as of December 31 to next year’s FTB account.
Your allowable reduction is the total of column A or $3,000, whichever is less, plus the interest earned on the principal
balance.
When you file your Montana income tax return electronically you represent that you have retained all documents
required as a tax record and that you will provide a copy to the department upon request.
158
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