Form Mrw Reg - Registration For Mineral Royalty Withholding (Mrw) Page 3
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3Mineral Royalty Withholding Registration Instructions
Line 1 – Federal Employer
section 1362 of the Internal
this category and attach an
Identifi cation Number or Social
Revenue Code (26.U.S.C. 1362)
explanation for the reason you are
Security Number. If you have been
Member Managed LLC – a
registering.
issued a federal identifi cation number
limited liability corporation,
Line 10 – List the previous name,
(FEIN or EIN) for this business, enter it
managed by its owner(s)
owner and date acquired, if you
on the boxes provided.
Manager Managed LLC – a
purchased an existing business,
limited liability corporation,
If you are operating your business as
or if there was a name change. If
managed by a chief executive
a sole proprietorship, enter your social
you purchased an existing business,
offi cer, or other appointed
security number. You do not have to
enter the name of the business you
management position
enter your SSN if you are registering
purchased, the owner you purchased
LLP – a limited liability partnership
this business under a FEIN.
the business from, and the date
Publicly Traded Partnership –
you purchased the business. If
Line 2 – Legal Business Name.
a publicly traded partnership as
you changed the legal name or the
Enter your legal business name. If you
defi ned in Section 7704 or the
assumed business name, enter the
are a sole proprietorship, enter your
Internal Revenue Code, 26 U. S.
previous business name.
name (example: John Smith). If you
C. 7704, that is not treated as a
are a corporation, partnership, LLP or
Line 11 – Type of Mineral
corporation
LLC, enter the entity’s name (example:
Production. Put an “X” next to the
Other – if your entity type is not
ABC Inc.).
type of mineral production you have
listed, note the type on the line
in the state of Montana. If you mark
provided and put an “X” in the box
Line 3 – Doing Business As (DBA).
“Other Mineral,” please indicate on the
following this choice.
Enter the doing business as name
line provided.
(DBA) here. This is the name used
Line 8 – Ownership Information.
before the public. For example, if the
Line 12 – Signature of Owner,
Enter the names, identifi cation
name used to report information to
Partner or Offi cer. An owner, partner
numbers and phone numbers for all
the Montana Board of Oil and Gas
or authorized company offi cer is
owners of the business. If more space
Conservation is different than your
required to sign, date and list a phone
is needed, please attach an additional
legal business name, enter here.
number.
sheet.
Line 4 – Physical Address. This
Line 13 – Print the name of the
Line 9 – Purpose of Registration.
is the legal business headquarters.
owner, partner or offi cer. Please
Put an “X” next to the category that
If you are a sole proprietor, this
print the name of the person who
describes the reason for registering.
may be your home address. For a
signed line 12.
This will help us determine if a
corporation, partnership, LLC or LLP,
new account is required, if an
Mail completed form to:
this is the street address of the entity’s
existing account will be closed, or if
Business Registration
headquarters.
modifi cations to an existing account
Montana Department of Revenue
are required.
Line 5 – Mailing Address. This
PO Box 5805
Initial Registration. See above.
may be a post offi ce box or other
Helena MT 59604
Started New Business. Mark this
address. This is the address
Or fax completed form to:
category if your business has not
where the department will send all
(406) 444-1505
previously existed under any other
correspondence.
name or owner.
Questions? Call us toll free at 1-866-
Line 6 – Contact Person. Enter the
Purchased Existing Business or
859-2254 (in Helena, 444-6900), or
name and contact information for the
Property. Mark this category if the
fax 406-444-0722.
individual that will act as the entity’s
business previously existed and
representative.
you purchased it (or producing
Line 7 – Legal Entity Type. Check
properties) from another owner.
the legal entity type that best
Re-registration. Mark this
describes your business:
category if you closed your
Sole Proprietor – an individual
account in the past, but have
owner of a business that has not
decided to begin operations again.
incorporated
Entity Change. Mark this category
Partnership – a business that has
if your entity has changed its legal
two or more owners
status. For example, if you were
C Corporation – an incorporated
formerly a sole proprietor, but
entity for federal and state tax
have recently incorporated, you
purposes
would use this category.
S Corporation – a corporation
Other. If you are registering
that has a valid election under
for a reason not listed, mark
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Parent category: Financial