MONTANA
QEC
Rev. 11-07
2007 Qualifi ed Endowment Credit
15-30-165 and 15-30-166, 15-31-161 and 15-31-162, MCA
Name (as it appears on your tax return) ________________________________________________________________
Your Social Security Number or Federal Employer Identifi cation Number ______________________________________
If this credit is a pass-through to you from a partnership or S corporation enter below the name, FEIN, and your
percentage of ownership in the partnership or S corporation.
Name ___________________________________________________ FEIN ______________ % of Ownership ________
1a.
Enter the name and address of the tax-exempt Montana organization, qualifi ed under 26 U.S.C. 501(c)(3), that is
holding the qualifi ed 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 qualifi ed 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.
Charitable remainder unitrust
Charitable remainder annuity trust
Pooled income fund trust
Charitable lead unitrust
Charitable lead annuity trust
Charitable gift annuity
Deferred charitable gift annuity
Charitable life estate agreement
Paid-up life insurance policy
Qualifi ed outright charitable contribution. An outright charitable contribution qualifi es 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 here the date the qualifi ed contribution was made. .............................................................3.
4.
Enter here 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 (40%) and enter the result here, but not more
than $10,000. If your gift is a qualifi ed outright charitable contribution, multiply line 4 by .20 (20%)
and enter the result here, but not more than $10,000. This is your Qualifi ed Endowment Credit. 5.
If you are an estate or trust, transfer the amount on line 5 to Form FID-3, Schedule III, line 3.
If you are an individual, transfer the amount on line 5 to Form 2, Schedule V, line 3.
If you are a C corporation, transfer the amount on line 5 to Form CLT-4, Schedule C, line 12.
If you are an S corporation, transfer the amount on line 5 to Form CLT-4S, Schedule II, line 9.
If you are a partnership, transfer the amount on line 5 to Form PR-1, Schedule II, line 9.
When you fi le 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.