Montana Form Frm - Montana Farm And Ranch Risk Management Account - 2012
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MONTANA
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FRM
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Rev 02 12
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2012 Montana Farm and Ranch Risk Management Account
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Annual Reporting Information
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15-30-3001 through 15-30-3005, MCA
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First Name and Initial
Last Name
Social Security Number
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Account Information
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Grantor Name _________________________________________________________________________________
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Federal Employer Identifi cation No.
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OR
Social Security No.
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Trustee Name _________________________________________________________________________________
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Address _________________________________________________
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Account Number __________________________________________
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Deposits
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You are considered to have made a deposit to an account if you make a deposit during a tax year or within 3 1/2 months
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after the close of a tax year.
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Date
Deposit
Date
Deposit
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______________________
______________________
_____________________
____________________
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______________________
______________________
_____________________
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______________________
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Total Deposits
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Deduction
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1. Net income attributable to your eligible agricultural business ............................................ 1. ____________________
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2. Enter 20% (0.20) of line 1 .................................................................................................. 2. ____________________
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3. Enter the total amount of the deposits that you have made ............................................... 3. ____________________
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4. Enter the smaller of line 2 or line 3, but not more than $20,000. This amount is your farm and ranch risk
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management account deposits that may be excluded from adjusted gross income. Enter this amount on
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Form 2, Schedule II ............................................................................................................ 4. ____________________
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Distributions
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Total
Taxable
Nontaxable
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Date
Amount
Amount
Amount
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Total Distributions
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If you fi le your Montana tax return electronically, you do not need to mail this form to us unless we ask you for a copy. When you fi le electronically,
you represent that you have retained the required documents in your tax records and will provide them upon the department’s request.
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*12DG0101*
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*12DG0101
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