Montana
CLEAR FORM
ATL
Rev 04 14
assumption of Montana tax Liabilities
Corporation 1
Name of corporation wishing to have its tax liability assumed:
_______________________________________________________________________________________
Organized under the laws of the state of _______________________________________________________
Federal Employer Identification Number (FEIN) __________________________
If you are filing as part of a combined Montana tax return, enter the name and FEIN shown on the return.
_______________________________________________________________________________________
Corporation 2
Name of corporation wishing to assume the Montana tax liabilities of Corporation 1:
_______________________________________________________________________________________
Organized under the laws of the state of _______________________________________________________
Federal Employer Identification Number ________________________________
Address _________________________________________________________
City/State/Zip Code ________________________________________________
If you are filing as part of a combined Montana tax return, enter the name and FEIN shown on the return.
_______________________________________________________________________________________
Certificate Type
In order to obtain from the Montana Department of Revenue (choose one):
a tax clearance certificate for Corporation 1
a dissolution/withdrawal certificate for Corporation 1
Affidavit and Signature
Corporation 2 hereby agrees to the following:
•
That the undersigned is an officer of Corporation 2 authorized to execute this assumption on its behalf;
•
To timely file or cause to be filed any Montana tax return, report or data that may be required by Corporation 1;
•
To pay or cause to be paid, in full, all accrued and accruing liabilities for tax, penalty and interest of
Corporation 1; and
•
That unless the liabilities assumed can be enforced as a tax of Corporation 2, any action to enforce this
assumption must be brought in the First Judicial District Court, Lewis and Clark County, State of Montana,
and each party shall pay its own costs and attorney fees.
Declaration: Under penalties 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 Officer
Date
_______________________________________________
______________________________
Title
Telephone Number
Mail to:
Montana Department of Revenue
PO Box 5805
Helena, MT 59604-5805