Rev 03 17
Affidavit of Inactivity for Corporations, Partnerships
and Disregarded Entities
Part I. Tax Period. This form must be completed for each period.
M M D D Y Y Y Y
1. Tax period end date
2. Is this your entity’s final period? Yes
Part II. Qualifications. Please mark the appropriate box for each question for the period indicated in Part I.
1. Do you have any type of income (sales, gains, etc.) from sources in Montana?
2. Do you have any employees or other representatives who perform work in Montana?
3. Do you have any property or rents in Montana?
4. Did you receive any distributive share of Montana source items from a pass-through entity?
If you answered yes to any of the above questions, you do not qualify for this form and must submit an applicable
Part III. Entity Information
1. Entity Name
2. Street Address
4. Contact Person
5. Contact Phone
6. Federal Employer Identification Number
7. Entity Type
8. Montana Secretary of State ID
Part IV. Affidavit and Signature
I am an authorized representative of the designated entity. I am acquainted with the affairs of this entity and that the
entity had no income or business activity of any nature in Montana for the tax period indicated in Part I above.
For C corporations, I understand that for each tax period the entity is either required to file an Affidavit of Inactivity or, if
the entity does engage in business or have any income in Montana, file a Montana Corporate Income Tax Return by the
due date prescribed in
For S corporations, partnerships and disregarded entities, I understand that for each tax period the entity is either
required to file an Affidavit of Inactivity or, if the entity does engage in business or have any income in Montana, file a
Montana S Corporation Information and Composite Tax Return, Partnership Information and Composite Tax Return or
Disregarded Entity Information Return by the due date prescribed in
Declaration: Under penalty of false swearing, I declare I have examined this document, and to the best of my
knowledge and belief, it is true, correct and complete.
Signature of Authorized Representative
Print Name of Authorized Representative
Title of Authorized Representative
Please return completed form to: Montana Department of Revenue, PO Box 5805, Helena, MT 59604-5805