Form Et911 - Emergency Telephone (911) Service Fee Return April 2006
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1MONTANA
ET911
Rev. 4-06
Emergency Telephone (911) Service Fee Return
10-4-101, MCA
Return and Instructions
Line 8
Enter total number of total, exempt, and taxable telephone access lines for each month.
Multiply line 8 (total number of taxable access lines, column c) by
.
Line 9
$0.50
Enter previously remitted fees found to be worthless and deducted as bad debt for federal income tax
Line 10
purposes.
Enter recapture of fees previously written off as bad debts.
Line 11
Enter total amount due. (sum of lines 8, 9, and 10).
Line 12
Enter amount paid with this return. This should equal line 12.
Line 13
Make check payable to the Department of Revenue. Mail this return and payment to:
Dep[artment of Revenue, PO Box 5835, Helena, MT 59604-5835
------------------------------------------------------Cut on this line----------------------------------------------------------
Montana Department of Revenue
Above space is for department use only
Emergency Telephone Service Fee (911)
7. Please check box if return is for:
Prepaid wireless provider
1. FEIN
2. Account ID
Wireline service provider
Internet service provider/VOIP
Wireless service provider
Other (please specify)_________
3. Period:
4. If this is an amended
Due
return, check here
Column a.
Column b.
Column c.
Total
Exempt
Taxable
8. Total number of access lines
5. If you are no longer in business and want your
Access Lines
Access Lines
Access Lines
account cancelled, enter the final date
______________
First month of quarter...............
6. If your mailing address has changed, check
Second month of quarter..........
the box and print new address below:
Third month of quarter..............
Total number of access lines....
9. Fee computation (total of column c, times $0.50)
$
|
Signature_______________________________________
10. Uncollectable fees
$ (
|
)
Title___________________________________________
___
11. Uncollectable fees recaptured
$
|
Phone__________________________Date___________
$
|
12. Total fees due (sum of lines 9, 10 and 11)
13. Enter amount paid
with this return
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Parent category: Financial