Montana Tribal Member Certification
Extracted from PDF file 2019-montana-form-ind.pdf, last modified May 2017
Tribal Member CertificationCLEAR FORM 2019 Enrolled Tribal Member Exempt Income Certification/Return First Name and Initial Last Name MONTANA ETM Rev 03 18 Social Security Number - - Mailing Address City State Zip Code Physical Address (not a post office box) City State Dates (at this address) From__________________ To_____________________ Physical Address (if you moved during the year) City State Dates (at this address) From__________________ To_____________________ Montana Tribe (of which you are an enrolled member) Tribal Enrollment Number 1. Did you reside on the reservation where you are an enrolled member? 2. Please check the statement that is true. Check only one. Yes No All of my income is exempt from Montana income tax; or I had both exempt and nonexempt income, but my non-exempt income was not enough to require that I file a Montana income tax return (Form 2). Part of my income for the year was exempt from Montana income tax, but I did have other non-exempt income that exceeds the Montana filing threshold. I am including this form with my completed Montana Form 2. 3. Enter your exempt income information in the table below. Employer’s Name (or source of exempt income) Street Address, City, State and Zip (not a PO Box) Employer Federal Employer Identification Number (FEIN) Income Type (wages, interest, etc.) Dates From - MMDDYYYY To MMDDYYYY From MMDDYYYY To MMDDYYYY From MMDDYYYY To MMDDYYYY I declare under penalty of false swearing that I am an enrolled member of the tribe identified above, that I possess the full rights of tribal membership, that I reside on the reservation identified above and all the information on this form and included with this form is true, correct and complete. Your Signature is Required X Paid Preparer’s Signature Daytime Telephone Number Paid Preparer’s PTIN/SSN Third Party Designee Do you want to allow another person (such as a paid preparer) to discuss this return with us? Yes Date Third Party Designee’s Printed Name Third Party Designee’s Phone Number No Important: Do not photocopy. *17DK0101* *17DK0101* Firm’s FEIN Form ETM Instructions Important! If you are a tribal member and all your income is exempt from Montana income tax, this form will serve as your return. You do not have to file Montana Form 2. ●● $4,710 if your filing status is single or married filing separately ($7,220 if you are 65 or older) If only part of your income is exempt from Montana income tax, you will need to include this form with Montana Form 2. ●● $9,420 if your filing status is married filing jointly with your spouse ($11,930 if you or your spouse is 65 or older and $14,440 if both spouses are 65 or older) Heading Print your name, mailing address, physical address(es) and social security number in the spaces provided. If you lived at more than two addresses during the year, include a separate sheet listing the locations and dates. Also include the name of the Montana tribe of which you are an enrolled member and your tribal enrollment number. ●● $9,420 if your filing status is head of a household ($11,930 if you are 65 or older) The filing threshold is increased by $2,510 if you are blind. Line 3 – Complete the exempt income information table. Provide the name of your employer(s) or the source of your exempt income. If you are self-employed, enter your business name. Line 1 – Check “Yes” if you resided on the reservation where you are an enrolled member for the entire year. Check “No” if you resided off the reservation where you are an enrolled member at any time during the year. If you are not self-employed, enter the FEIN of your employer. If you are a wage earner, this information will be available on the federal Form W-2 you received from your employer. Line 2 – Check the box next to the statement that is true. Mark the first box if either of the following applies to you: 1. all of your income is exempt or, 2. you had both exempt and non-exempt income but the non-exempt amount did not exceed the filing threshold for your age and filing status. Enter the physical address where the wages were earned or services provided and the dates work was performed. If necessary, attach a sheet listing additional income claimed as exempt. Also, check this box and submit it with Form 2 in order to request a refund of any Montana tax withheld or payments you made. Mark the second box if you had both exempt and nonexempt income and your non-exempt income exceeded the applicable filing status. If this is the case, you are required to file Form 2 to pay Montana income tax on the nonexempt portion of your income. Income is exempt from Montana income tax if all of the following requirements are met: ●● You are an enrolled tribal member of the governing tribe of a reservation; ●● You resided and worked on that reservation; and ●● You earned the income by working on that reservation. The following income is not exempt from Montana income tax: Enter the type of income received that is exempt from Montana income tax. Do not enter the amount. Signature Block This is not considered a valid certification or return unless you sign it. If you are filing electronically, the act of filing electronically signifies your declaration, under the penalty of false swearing, that: ●● You are the taxpayer identified on the form; and ●● The information in the claim is true, correct and complete. If you want to allow your preparer, a friend, a family member or any other person you choose to discuss this form with the department, mark the “Yes” box in the Third Party Designee section of the signature block. You must also enter the designee’s printed name and phone number. If you do not complete this section in its entirety, we cannot discuss this form with a third party. Where to File ●● Income you earn from working on a reservation where you are not an enrolled tribal member of the governing tribe You can file Form ETM online for free. Go to https://tap.dor.mt.gov TransAction Portal (TAP), and click on “File A Return.” ●● Income you earn from working outside the reservation where you are an enrolled member, including income you earned in another state You can also mail Form ETM to: ●● Income you earn while you are not residing on the reservation where you are an enrolled member. You are required to file Form 2 if your non-exempt income exceeds the filing threshold. The threshold for filing depends on your filing status. For 2019, the filing thresholds are as follows: Montana Department of Revenue PO Box 6577 Helena, MT 59604-6577 Administrative Rules of Montana: 42.15.220 Questions? For additional information regarding the taxation of Native Americans or the third party designation, please visit mtrevenue.gov. You may also call us at (406) 444-6900.
More about the Montana Form IND Individual Income Tax TY 2019
Replaced by form ETM.
We last updated the Tribal Member Certification in March 2020, so this is the latest version of Form IND, fully updated for tax year 2019. You can download or print current or past-year PDFs of Form IND directly from TaxFormFinder. You can print other Montana tax forms here.
Other Montana Individual Income Tax Forms:
|Form Code||Form Name|
|Form 2||Montana Individual Income Tax Return|
|Form IT Payment Voucher||Individual Income Tax Payment Voucher|
|Form 2 Instructions||Individual Income Tax Instructional Booklet|
|Form AMD||Montana Individual Income Tax Amended Return Reconciliation|
Montana usually releases forms for the current tax year between January and April. We last updated Montana Form IND from the Department of Revenue in March 2020.
About the Individual Income Tax
The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.
Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!
Historical Past-Year Versions of Montana Form IND
We have a total of seven past-year versions of Form IND in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
While we do our best to keep our list of Montana Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.