Fill and Sign the Type of Certificate Requested Form

Entity name:_______________________________________________________________________ Indicate your filing type: C. Corporation___ S. Corporation___ LLC taxed as a partnership___ LLC taxed as a corporation___ Enter your Federal ID Number:___________________________________________________________ Enter the date that the entity was formed:___________________________________________________ Enter the state in which the entity was formed:_______________________________________________ If you file as a corporation, please complete the following: Are you filing a combined return? yes___ no___ If yes, enter the parent’s: Name_________________________________________________________ FEIN__________________________________________________________ Are you a nonprofit organization? yes___ no___ A corporation must qualify for tax exempt status prior to receiving a certificate. (See instructions) Indicate whether your entity is: Withdrawing____ Dissolving____ Merging____ Reinstating____ If merging, please provide the following for the surviving entity: Name_________________________________________________________ FEIN__________________________________________________________ If your company is included in the Montana filing of another company, you have to file an Assumption of Tax Liability. If you would like an Assumption of Tax Liability faxed to you, enter your fax number here:____________________ Where would you like us to send your certificate? Name:___________________________________________________________________ Address:_________________________________________________________________ ________________________________________________________________________ Contact phone:___________________________________________________________________ Check this box if you would like the original certificate to be sent directly to the Secretary of State. Please note: In order for the certificate to be sent directly to the Secretary of State, all necessary paperwork has to be first filed with their office. Signature of officer:_______________________________ Date:_______________________ Print name and title:__________________________________________________________ Send or fax this request to: Montana Department of Revenue Montana Department of Revenue Phone: (406) 444-6900 Attn: CertificatesFax: (406) 444-6642 PO Box 8021 Helena, MT 59604-8021 For Office Use Only: MONTANA CR-T Rev. 2-06 Tax Certificate Request 207 Type of certificate requested ____Title 15 ____Dissolution/Withdrawal ____Reviver ____Tax Clearance To withdraw/dissolve To reinstate with Secretary To verify that with the Secretary of State of State after being your final return suspended by DOR was filed requirements are current ____Good Standing To show that your filing and payment Instructions on back To reinstate with the Secretary of State after being involuntarily dissolved. Tax Certificate Request Instructions If the filing of tax returns is necessary before a certificate can be issued, please submit copies of these returns along with this form. This will expedite the process. Nonprofit Organizations If your organization has registered as a nonprofit organization with the Secretary of State but has not yet qualified for tax-exempt status with the Department of Revenue, the following information needs to be filed for your organization to establish tax-exempt status and to subsequently receive any certificate: 1. an affidavit stating the purpose of the organization 2. articles of incorporation 3. by-laws 4. financial statements 5. a copy of the IRS letter granting federal tax-exempt status if available. Certificates - Secretary of State Title 15 Certificate (T-15) – To reinstate the corporation with the Secretary of State, all tax returns have to be submitted and all taxes paid prior to issuing a certificate. In the event that there was no activity, the corporation can file an Affidavit of Corporate Inactivity (Form INA-CT). This form is available on our website, www.mt.gov/ revenue. Dissolution/Withdrawal Certificate (DWC) – For purposes of voluntary withdrawal or dissolution with the Secretary of State, Section 15-31-552, MCA provides for a DWC. This certificate verifies that the corporation has filed all applicable returns and has paid all taxes owing the state of Montana up to the date of request for dissolution or withdrawal. The corporation remains responsible for the filing of a final return upon its withdrawal or dissolution (see TCC below). Certificate of Reviver – If the Department of Revenue, rather than the Secretary of State, suspended your organization, you will need to request a Certificate of Reviver as well as a Title-15 Certificate. There are no fees charged for any certificate. Upon issuance, your organization will receive an original certificate along with a copy. Both of these certificates must be submitted to the Secretary of State, Business Services Bureau at the following address: Secretary of StatePhone (406) 444-3665 Business Services Bureau P.O. Box 202801 Helena, MT 59620-2801 Tax Clearance Certificate (TCC) – At the time of final withdrawal or dissolution, the Department of Revenue upon request, will furnish to a corporation a TCC verifying that the corporation has filed all applicable returns and that all taxes have been paid through and including the corporation’s final year of existence in Montana. This certificate is not required to be filed with the Secretary of State. Good Standing Certificate – Upon request by the taxpayer, a Good Standing Certificate is available from the Department of Revenue which will serve as confirmation that the corporation has filed all tax returns and paid all taxes. This certificate is not filed with the Secretary of State. Instead, it is requested by the taxpayer for verification to outside parties, such as financial institutions, that the taxpayer has no outstanding tax obligation. Optional Certificates