Form Mine-Cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits Page 5
Download a blank fillable Form Mine-Cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Mine-Cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7Applicant Name__________________________________
Part VI. Personnel Information
A.
Enter the number of employees
_____________
B.
List the names of consultants (if necessary, provide the list on an additional page).
1. ______________________________________________________________________
2. ______________________________________________________________________
3. ______________________________________________________________________
4. ______________________________________________________________________
5. ______________________________________________________________________
Part VII. Identification of Business type
Please mark the box that describes the type of entity applying for the credit.
a partnership registered to do business in the state,
a corporation qualified to do business in the state,
a limited liability company qualified to do business in the state,
a sole proprietorship, or
other, please explain __________________________________________________________________________
Part VIII. Applicant’s Signature
I, ______________________________________________________, under penalty of false swearing, declare that the
information provided in this application and attachments is true, correct and complete.
X ___________________________________________________________ (Signature of applicant)
Subscribed and sworn before me this _______ day of _______________________, 20 ________
Signature of notary ________________________________________________________________________________
My commission expires______________________________________________________________________________
Part IX. Department of Revenue Expenditure Certification/Denial
Amount of certified expenditures ............................................................................ $ _________________________
(Must match the amount shown in Part I)
Date of delivery of above data and request for approval of taking credit ................ _________________________
Month and Year
Signature and date for certifying expenditures
________________________________________________________________
_________________________
Name and Title
Date
Signature and date for not certifying expenditures (See separate letter for reasons of denial and remedy)
________________________________________________________________
_________________________
Name and Title
Date
Mail to: Montana Department of Revenue, Corporation Tax Unit, PO Box 7149, Helena, MT 59604-7149
Page 5
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Mine-cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits
Financial
Montana Form Mine-cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2006
Financial
Montana Form Mine-cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2010
Financial
Montana Form Mine-cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2009
Financial
Montana Form Mine-cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2012
Financial
Related Categories
Parent category: Financial