Mtq Schedule B - Montana Quarterly Payment Recap/adjustment Form

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MTQ SCHEDULE B
MONTANA QUARTERLY PAYMENT RECAP/ADJUSTMENT FORM
Complete and submit with MTQ
Complete customer information as shown on MTQ
Employer Name:
Customer Id:
Federal Id (FEIN) :
Quarter End Date:
You must complete this schedule if you are an accelerated/monthly payer. If you are adjusting any
payment period, please complete the adjustment column(s) and provide an explanation.
Deposit
Period
Montana Income Tax Withholding
Additional
Date Paid
End
Paid
Adjustment
Date
Withheld
Amount Paid
(+ --)
TOTAL
ADJUSTMENT EXPLANATION____________________________________________OVERPAYMENT_____________
_______________________________________________________________________REFUND__________________
_______________________________________________________________________CREDIT___________________
Customer Service Center
Telephone (406) 444-6900 Fax (406) 444-0629
Internet Address
WB104F_01

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