Fillable Montana Form Expt - Tax-Exempt Status Request Form printable pdf download

Montana Form Expt - Tax-Exempt Status Request Form

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MONTANA

CLEAR FORM

EXPT

Rev 03 17

Tax-Exempt Status Request Form

15-31-102,

MCA,

ARM 42.9.109

and

42.23.103

Please type or print the information required in the boxes below.

Entity Type

501(c)(3)

HOA

ESOP/ESOT

IRA

Pension Trust

(check all that apply)

Other_________________________

Public Charity

Private Foundation

Name of Organization

FEIN

Address

Secretary of State ID

City, State and Zip Code

Tax Year End (if applicable)

M M D D

Contact Person

Telephone Number

Have you received an exemption certificate or letter from the IRS? (check one)

Yes

Applied For

If Yes, please attach a copy with this form and provide the items listed below.

If No or Applied For, please submit the items listed below and refer to the instructions.

Entities engaged in business in Montana are required to file an annual Montana Business Income Tax Return, unless they

have tax-exempt status granted by the Montana Department of Revenue. For the department to grant tax-exempt status,

an entity generally must provide copies of the following:

1. Affidavit showing the character of the organization, the purposes for which it was organized, its actual activities,

the sources and disposition of its income, and whether any of its income may inure to the benefit of any private

shareholder or individual. (The affidavit does not need to be notarized.)

2. Articles of Incorporation

3. By-laws

4. Latest financial statement showing assets, liabilities, receipts and disbursements (for example, current bank

statement or spreadsheet showing income and expenses)

This list is by no means all inclusive and applicability will vary based on your entity type. For a specific listing of required

items for special types of entities, please refer to the instructions.

Print Name

Title

Signature

Date

Mail application to Montana Department of Revenue, Corporate Income Tax Unit, PO Box 5805, Helena, MT 59604-5805.

Fax application to (406) 444-2900.

Montana Form Expt - Tax-Exempt Status Request Form

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