Montana Form Ind - Indian Certification
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1MONTANA
IND
Rev. 4-02
Indian Certification
This form must be completed and attached to your tax return every year.
This is to certify the record of ______________________________________________________
Tribe
at ______________________________, Montana, shows ________________________________
City
Person
is an enrolled member of the tribe and possesses all the rights of membership equivalent to any other
member.
Social Security No. _____________________________________
Enrollment No. ________________ ______________________________ _______________________
Authorizing Officer
Date
I declare that I am a full tribal member enrolled, residing and earning all income for which I claim an ex-
emption on the reservation of the above named tribe.
______________________________________________________
____________________________
Tribal Member
Date
Indian Reservation Income
Effective January 1, 1994, Native American Indians who do not reside and work on the reservation of the tribe
in which they are enrolled will be subject to Montana tax on all income whether earned on or off the reserva-
tion.
Native American Indians working in Montana are required to file a Montana tax return even if the income
earned is exempt from Montana tax.
Any loss incurred on the reservation cannot be used to offset taxable income. Certification of enrollment
(Form IND) and proof the income was earned on the reservation must be attached to the return each year.
Montana Department of Revenue
Post Office Box 5805
Helena, MT 59604-5805
!
Questions? Please call (406) 444-6900 or TDD (406) 444-2830 for hearing impaired.
Attach this form to your return
122
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