Montana Form Qec - Qualified Endowment Credit - 2009
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1MONTANA
Clear Form
QEC
Rev. 07-09
2009 Qualified Endowment Credit
15-30-2327 and 15-30-2328, 15-31-161 and 15-31-162, MCA
Name (as it appears on your tax return) ________________________________________________________________
Your Social Security Number or Federal Employer Identification Number ______________________________________
If this credit was passed through to you from a partnership or S corporation, please indicate the name and FEIN of the
partnership or S corporation and your percentage of ownership in the partnership or S corporation.
Name __________________________________________ FEIN _________________ Percent of Ownership _______ %
1a. Enter the name and address of the tax-exempt Montana organization, qualified under 26 U.S.C. 501(c)(3), that is
holding the qualified endowment:
Name
_______________________________________________________________________________
Address
_______________________________________________________________________________
City, State, Zip _______________________________________________________________________________
1b. Enter the name and address of the trustee that is administering the planned gift:
Name
_______________________________________________________________________________
Address
_______________________________________________________________________________
City, State, Zip _______________________________________________________________________________
1c. Enter the name and address of the bank or trust company holding the qualified endowment on behalf of a
tax-exempt organization:
Name
_______________________________________________________________________________
Address
_______________________________________________________________________________
City, State, Zip _______________________________________________________________________________
2. Check the appropriate box indicating the type of gift you contributed.
q Charitable remainder unitrust
q Charitable remainder annuity trust
q Pooled income fund trust
q Charitable lead unitrust
q Charitable lead annuity trust
q Charitable gift annuity
q Deferred charitable gift annuity
q Charitable life estate agreement
q Paid-up life insurance policy
q Qualified outright charitable contribution. An outright charitable contribution qualifies for this credit only when a
C corporation, S corporation, partnership, trust, estate, or limited liability company makes the contribution. An
individual cannot claim this credit for an outright charitable contribution.
3. Enter the date the qualified contribution was made.......................................................................3.
4. Enter the present value of the aggregate amount of the charitable gift portion of your planned gift,
or your outright charitable contribution (the charitable deduction amount). ..................................4.
5. If your gift is a planned gift, multiply line 4 by 40% (0.40) and enter the result here, but not more
than $10,000. If your gift is a qualified outright charitable contribution, multiply line 4 by 20%
(0.20) and enter the result here, but not more than $10,000. This is your qualified endowment
credit. ............................................................................................................................................5.
If you are an individual, transfer the amount on line 5 to Form 2, Schedule V.
If you are a C corporation, transfer the amount on line 5 to Form CLT-4, Schedule C.
If you are an S corporation, transfer the amount on line 5 to Form CLT-4S, Schedule II.
If you are a partnership, transfer the amount on line 5 to Form PR-1, Schedule II.
If you are an estate or trust, transfer the amount on line 5 to Form FID-3, Schedule G.
When you file your Montana income tax return electronically, you represent that you have retained all documents required
as a tax record and that you will provide a copy to the department upon request.
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