Form LIQ-AUTH "Alcoholic Beverage Control Division Authorization to Disclose Tax Information" - Montana

What Is Form LIQ-AUTH?

This is a legal form that was released by the Montana Department of Revenue - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Montana Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LIQ-AUTH by clicking the link below or browse more documents and templates provided by the Montana Department of Revenue.

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Download Form LIQ-AUTH "Alcoholic Beverage Control Division Authorization to Disclose Tax Information" - Montana

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MONTANA
CLEAR FORM
LIQ-AUTH
LCD 7
Rev 03 19
Alcoholic Beverage Control Division
Authorization to Disclose Tax Information
This form authorizes the Alcoholic Beverage Control Division specialist(s) to acquire confidential taxpayer information from
the Business and Income Taxes Division for the named taxpayer(s) on this form.
Note: Each individual, partner, member, shareholder and/or entity must each complete a separate authorization form.
1. Taxpayer Information
Social Security Number
Name of Taxpayer/Applicant/Licensee
-
-
Alcoholic Beverage License Number
Federal Employer Identification
Number
Business Name
-
Address
City
State
Zip Code
Telephone Number
Fax Number
Email Address
2. Authorization of Representative
Name of Representative
Name of Firm (if applicable)
Licensing and Compliance Specialist
Montana Department of Revenue
Address
2517 Airport Road
City
State
Zip Code
Helena
Montana
59601
Telephone Number
Fax Number
406-444-6900
(406) 444-6642
3. Signature
If a tax matter concerns a joint return, both husband and wife need to sign. A signature by both is not required in any
other circumstance. A signature by a corporate officer, partner, guardian, executor, receiver, administrator, or trustee
on behalf of the taxpayer certifies that the signer has the authority to execute the form on behalf of the taxpayer.
We cannot honor this authorization of disclosure if it is not signed and dated.
_________________________________________
___________
__________________________________
Signature
Date
Title (if applicable)
_________________________________________
Print Name
_________________________________________
___________
Signature of Spouse (if applicable)
Date
_________________________________________
Print Name of Spouse
Authorization takes effect once the Montana Department of Revenue receives this form. This form applies only to a
Alcoholic Beverage Control Division application for licensing.
Filing this Form
Please mail or fax this form to:
Montana Department of Revenue
Attn: Alcoholic Beverage Control Division Authorization
PO Box 7149
Helena, MT 59604-7149
Fax: (406) 444-6642
MONTANA
CLEAR FORM
LIQ-AUTH
LCD 7
Rev 03 19
Alcoholic Beverage Control Division
Authorization to Disclose Tax Information
This form authorizes the Alcoholic Beverage Control Division specialist(s) to acquire confidential taxpayer information from
the Business and Income Taxes Division for the named taxpayer(s) on this form.
Note: Each individual, partner, member, shareholder and/or entity must each complete a separate authorization form.
1. Taxpayer Information
Social Security Number
Name of Taxpayer/Applicant/Licensee
-
-
Alcoholic Beverage License Number
Federal Employer Identification
Number
Business Name
-
Address
City
State
Zip Code
Telephone Number
Fax Number
Email Address
2. Authorization of Representative
Name of Representative
Name of Firm (if applicable)
Licensing and Compliance Specialist
Montana Department of Revenue
Address
2517 Airport Road
City
State
Zip Code
Helena
Montana
59601
Telephone Number
Fax Number
406-444-6900
(406) 444-6642
3. Signature
If a tax matter concerns a joint return, both husband and wife need to sign. A signature by both is not required in any
other circumstance. A signature by a corporate officer, partner, guardian, executor, receiver, administrator, or trustee
on behalf of the taxpayer certifies that the signer has the authority to execute the form on behalf of the taxpayer.
We cannot honor this authorization of disclosure if it is not signed and dated.
_________________________________________
___________
__________________________________
Signature
Date
Title (if applicable)
_________________________________________
Print Name
_________________________________________
___________
Signature of Spouse (if applicable)
Date
_________________________________________
Print Name of Spouse
Authorization takes effect once the Montana Department of Revenue receives this form. This form applies only to a
Alcoholic Beverage Control Division application for licensing.
Filing this Form
Please mail or fax this form to:
Montana Department of Revenue
Attn: Alcoholic Beverage Control Division Authorization
PO Box 7149
Helena, MT 59604-7149
Fax: (406) 444-6642
Alcoholic Beverage Control Division
Authorization to Disclose Tax Information
Section 1. Taxpayer Information
This form authorizes the Montana Department of
Revenue Alcoholic Beverage Control Division staff to
Each business entity or owner needs to independently
access your confidential tax information. This access
complete this form. The seller may not inquire for the
allows the specialist to verify compliance with filing
applicant or vice versa.
and payment of taxes in Montana.
Entities applying for a license—including C
Section 3. Signature
corporations, S corporations, LLCs taxed as
partnerships, LLCs taxed as corporations and LLCs
Individual. Please sign and date the form. If you are
taxed as sole proprietors—need to complete this form.
filing a joint return with your spouse, you and your
Individual license holders, members, shareholders,
spouse both need to sign.
and other owners with 10% or greater interest in a
Corporation or association. An officer with authority
business entity must complete the disclosure form.
to bind the corporation needs to sign.
Individual. Enter the requested information in
Partnership. All partners need to sign unless one
the boxes provided. Please do not enter your
partner is authorized to act in the name of the
representative’s address or post office box as your
partnership. A partner is authorized to act in the name
own. If you and your spouse are filing a joint return and
of the partnership if, under state law, the partner
are designating the same representative(s), also enter
has authority to bind the partnership. A copy of such
your spouse’s information, if different from yours.
authorization must be attached.
Corporation, partnership, limited liability company,
LLC. If the LLC is member-managed, all members
or association. Enter the name, FEIN, telephone
need to sign, unless one member is authorized to act in
number, and business address. If this form is being
the name of the LLC. A copy of such authorization must
prepared for corporations filing a combined tax return,
be attached. If the LLC is overseen by a manager, the
a list of subsidiaries is required.
manager needs to sign.
Trust. Enter the name, title, telephone number, and
Estate, trust, or other fiduciary. The personal
address of the trustee, and the name and FEIN of the
representative of an estate needs to sign. The trustee
trust.
of a trust needs to sign. If a guardian or conservator
Estate. Enter the name, title, and address of
has been appointed for a taxpayer, that person needs
the decedent’s personal representative, and the
to sign. In all cases, the fiduciary needs to specify
name and identification number of the estate. The
the representative capacity in which that person is
identification number for an estate includes both the
signing, such as “John Doe, guardian of Jane Doe.”
FEIN, if the estate has one, and the decedent’s SSN.
Filing this Form
Section 2. Authorization of Representative
Each individual and entity associated with your
alcoholic beverage license needs to complete a
This information has been entered for you.
separate authorization form. You will need to mail or
Purpose of this Form
fax this form to the address or number shown below.
Before the Montana Department of Revenue’s
Important: Please do not include this authorization
Alcoholic Beverage Control Division can approve
form with your liquor license application.
any type of transfer, issuance, or corporate structure
Mail to:
Montana Department of Revenue
change of any alcoholic beverage license, a person
Attn: Alcoholic Beverage Control
has to comply with Montana’s licensing criteria.
Division Authorization
This process requires that sellers and applicants be
PO Box 7149
in good standing with the Montana Department of
Helena, MT 59604-7149
Revenue Business and Income Taxes Division.
Fax to:
(406) 444-6642
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