Montana Form Ct-203 - Insignias Refund Application - 2005 Page 2
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2Schedule M – Insignias Refund Recap
For the period of ___________________________________________
Business name ____________________________________________ Phone _________________________
Invoices Information
Number of
Tax /
Credit
Total Tax
packs
Pack
Memo ID
(A X B = C)
(A)
(B)
Business Name
Address
City
State
Zip
Phone
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
$
20/Pk - $1.70
$
25/Pk - $2.125
–
$
Total column C this page
Add total tax for this page only ....................................................................................................................................
$
Total refund from all pages – Fill on last page only; total column C value on CT-203 line 1, section 1 ...............................................................
343
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