Montana Form Pt-Stm - Second-Tier Pass-Through Entity Owner Statement And Waiver Request

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MONTANA
CLEAR FORM
Form PT-STM
Rev 05 13
Second-Tier Pass-Through Entity Owner
Statement and Waiver Request
For tax year beginning
M M D D Y Y Y Y
and ending
M M D D Y Y Y Y
First-Tier Pass-Through Entity Information
Name
FEIN
-
Mailing Address
Entity Type Code
City
State
Zip Code + 4
1.
Will the fi rst-tier pass-through entity fi le an initial return this year?
Yes
No
2.
Will the fi rst-tier pass-through entity fi le a fi nal return this year?
Yes
No
Second-Tier Pass-Through Entity Information
Name
FEIN
-
Mailing Address
Entity Type Code
City
State
Zip Code + 4
1.
Will the second-tier pass-through entity fi le an initial return this year?
Yes
No
2.
Will the second-tier pass-through entity fi le a fi nal return this year?
Yes
No
3.
Will the second-tier pass-through include all of its owners in a composite income tax return?
Yes
No
If the answer is yes, do not complete page 2.
Waiver Request
If a fi rst-tier pass-through entity properly completes Form PT-STM, establishing that the second-tier pass-through entity’s distributive
share of Montana source income will be fully accounted for in Montana income tax returns, the requirement to fi le a composite return
or pay tax on behalf of the second-tier pass-through entity is waived on the condition that the fi rst-tier entity agrees to pay amounts that
should have been remitted within 60 days after notice from the department that all Montana returns were not fi led or all Montana taxes
have not been paid.
Multiple Year Request
If a fi rst-tier pass-through entity requests a conditional waiver of the requirement to withhold or include a second-tier pass-through entity
in a composite return for multiple tax years, the fi rst-tier pass-through entity must agree to notify the department if the ownership of the
second-tier pass-through entity and the ownership of any higher-tier entity changes and agree to pay amounts that should have been
remitted within 60 days after notice from the department that all Montana returns were not fi led or all Montana taxes have not been
paid.
The fi rst-tier pass-through entity agrees to these terms and requests a multiple year waiver.
Yes
No
First-Tier Entity Signature
I, the undersigned, declare under penalty of false swearing, that I am authorized to make this statement and request this waiver
on behalf of the fi rst-tier pass-through entity, and that the statement, including all accompanying attachments, is, to the best of my
knowledge and belief, true, correct and complete.
Signature
Date
M M D D Y Y Y Y
Printed Name of Signatory
Title
Indicate the number of pages included with the Form PT-STM (including this page).
*13EB0101*
*13EB0101*

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