Form Genreg - Registration/application For Permit
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2
3MONTANA
GenReg
Rev 05 12
Registration/Application for Permit
If you prefer to register electronically, go to revenue.mt.gov.
Mark
the appropriate box(es) for the tax type(s) you are registering.
X
Lodging Facility Tax
Rental Vehicle Tax
Withholding Tax
1. Federal Employer Identification Number
-
OR
Social Security Number
-
-
2. Date you are starting business in Montana
M M
/
D D
/
Y Y Y Y
3. Legal Owner’s Name _______________________________________________________________________
4. Doing Business As ________________________________________________________________________
5. Legal Business Address (must be a street address) ____________________________________________________
City _____________________________________________ State _______________ Zip Code ________________
6. Mailing Address ________________________________________________________________________________
City _____________________________________________ State _______________ Zip Code ________________
7. Contact Person ____________________
Phone
Fax
(
)
-
(
)
-
E-mail _______________________________________________
8. Type of Business (mark
all that apply)
X
Individual
Partnership
LLP
Domestic Help
LLC (mark
one below)
X
Member Managed
S Corporation
Corporation
Government
Church
Agricultural
Manager Managed
9. Reason for Application (Mark
the applicable box and complete section below if indicated. See instructions on back.)
X
Started new business
Purchased existing business
Re-registration
Other–please attach explanation
Complete the following sections as required. Attach additional pages if necessary.
10. Individual Business
_________________________________________________________________________________
Owner Name
-
-
(
)
-
Social Security Number
Phone
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