Form Der-1 - Montana Disregarded Entity Information Return - 2009 Page 2
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4Schedule I
Disregarded entity name ____________________________ Tax period ending ____________________________________ SSN/FEIN ___________________
Disregarded Entity Owner Information
Enter the total number of owners _____
Complete columns E through G for a nonresident individual, foreign C corporation or second tier pass-through entity owner
Nonresident individual, foreign C corporation and
All Owners
second tier pass-through entity owner information
A
B
C
D
E
F
G
Montana corporation
Montana individual
Consent
Owner
Name
Identifi cation Number
Ownership
Montana source
tax withheld. Multiply
tax withheld. Multiply
agreement
Street Address
%
income
column D by 6.75%
column D by 6.9%
or statement
SSN/FEIN
City | State | Zip Code
and enter result.
and enter result.
(year)
1.
SSN
FEIN
2.
SSN
FEIN
3.
SSN
FEIN
4.
SSN
FEIN
5.
SSN
FEIN
6.
SSN
FEIN
7.
SSN
FEIN
Column Totals
Use additional sheets if necessary or you may use a document formatted similarly to Schedule I as a substitute.
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Parent category: Financial