Form Rw-3 - Montana Annual Mineral Royalty Withholding Tax Reconciliation - 2010 Page 2
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1
2CLEAR FORM
MONTANA
RW-3
2010
Rev 10 10
Montana Annual Mineral Royalty Withholding Tax Reconciliation
_______________________________
FEIN
Name
M R
W
______________________________
Account ID
Address
Not Required
________________________________
______________________________
City
Pay Frequency
0 2 2 8 2 0 1 1
________
___________________
Due Date
State
Zip
May the DOR discuss this return with your tax preparer?
► If this is an amended return, check here
If “Yes,” provide preparer name and telephone below.
Yes
No
► If this is your fi nal return, check here
____________________________________
1. Number of 1099-MISCs with Montana withholding
Paper
Electronic
2. Number of 1099-MISCs without Montana withholding
Paper
Electronic
If you were not required to withhold Montana mineral royalty tax in 2010, please do not complete lines 3 through 8.
3. Total Montana net royalty payments subject to withholding
0
.
4. Total Montana tax withheld per 1099-MISC
0
.
5. Total Montana mineral royalty withholding tax paid
0
.
6. Difference (line 4 minus line 5)
0
.
If you have an overpayment on line 6, please check
7.
Please send refund
Please apply to a future liability
the appropriate box
Use additional sheets if necessary, or you may use a document with columns ordered as shown below.
B
Quarterly
A
C
D
E
Montana Net Royalty
Report
Date(s) Paid to MT
Montana Tax Withheld
Montana Tax Paid
Difference
Payment
Period
DOR
No slashes or dashes
2010
in dates please!
MM DD YYYY
Jan-Mar
MM DD YYYY
Apr-June
MM DD YYYY
July-Sept
MM DD YYYY
Oct-Dec
8. Column Totals
Please provide an explanation if there is a difference on line 8, Column E
_________________________________________________
*15070101*
1507
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