Form MDT-IFTA-002 "International Fuel Tax Agreement (Ifta) New Carrier Application" - Montana

What Is Form MDT-IFTA-002?

This is a legal form that was released by the Montana Department of Transportation - 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 November 1, 2018;
  • The latest edition provided by the Montana Department of Transportation;
  • 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 MDT-IFTA-002 by clicking the link below or browse more documents and templates provided by the Montana Department of Transportation.

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Download Form MDT-IFTA-002 "International Fuel Tax Agreement (Ifta) New Carrier Application" - Montana

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Montana Department of Transportation
PO Box 4639
Helena MT 59604-4639
International Fuel Tax Agreement (IFTA)
(406) 444-2998
MDT-IFTA-002
Rev. 11/18
New Carrier Application
Page 1 of 2
Do Not Write in this Space
IFTA License #
1. License Eff Date
:
3. USDOT #
2. Business Federal Employer ID #
(1st date of operation)
4. Legal Name
5. Trade Name (DBA):
6. Mailing Address
7. Physical Address
(if different than mailing)
Zip Code
Zip Code
City
State
State
City
MT
MT
8. Business Phone Number
9. Fax Number
10. Email Address
11. Fuel Types
Diesel
Gasoline
Propane
Other
12. Type of Organization
Individual
Partnership
Corporation
LLC
13. List Owners, Partners, or Corporate Officers
Phone
Driver's
DL
Name
Address
City
State Zip
Number
Title
License #
State
14. Three forms of Proof of Residency included?
Yes
No
(see Page 2 for types)
15. Do you maintain bulk storage in Montana?
Yes
No
16. List Other States Where Bulk Fuel is Maintained:
17. If you have ever been licensed in another jurisdiction please list:
18. Has your IFTA license ever been revoked? If yes Where?
Yes
No
19. Number of IFTA vehicles needing decals
Under penalties of perjury, I certify with my signature that to the best of my knowledge the information and statements on this application are
true and correct and the number shown on this form is my correct taxpayer identification number. I agree to comply with reporting, payment,
record keeping and license display requirements as specified in the International Fuel Tax agreement and Montana Statutes. I further agree
that Montana may withhold any refunds due me if I become delinquent in payment of fuel taxes, whether due Montana or any IFTA member
jurisdiction. I also understand that failure to comply with these provisions shall be grounds for revocation of my IFTA license.
Authorized Signature
Title / Third Party
Date
Montana Department of Transportation
PO Box 4639
Helena MT 59604-4639
International Fuel Tax Agreement (IFTA)
(406) 444-2998
MDT-IFTA-002
Rev. 11/18
New Carrier Application
Page 1 of 2
Do Not Write in this Space
IFTA License #
1. License Eff Date
:
3. USDOT #
2. Business Federal Employer ID #
(1st date of operation)
4. Legal Name
5. Trade Name (DBA):
6. Mailing Address
7. Physical Address
(if different than mailing)
Zip Code
Zip Code
City
State
State
City
MT
MT
8. Business Phone Number
9. Fax Number
10. Email Address
11. Fuel Types
Diesel
Gasoline
Propane
Other
12. Type of Organization
Individual
Partnership
Corporation
LLC
13. List Owners, Partners, or Corporate Officers
Phone
Driver's
DL
Name
Address
City
State Zip
Number
Title
License #
State
14. Three forms of Proof of Residency included?
Yes
No
(see Page 2 for types)
15. Do you maintain bulk storage in Montana?
Yes
No
16. List Other States Where Bulk Fuel is Maintained:
17. If you have ever been licensed in another jurisdiction please list:
18. Has your IFTA license ever been revoked? If yes Where?
Yes
No
19. Number of IFTA vehicles needing decals
Under penalties of perjury, I certify with my signature that to the best of my knowledge the information and statements on this application are
true and correct and the number shown on this form is my correct taxpayer identification number. I agree to comply with reporting, payment,
record keeping and license display requirements as specified in the International Fuel Tax agreement and Montana Statutes. I further agree
that Montana may withhold any refunds due me if I become delinquent in payment of fuel taxes, whether due Montana or any IFTA member
jurisdiction. I also understand that failure to comply with these provisions shall be grounds for revocation of my IFTA license.
Authorized Signature
Title / Third Party
Date
Montana Department of Transportation
PO Box 4639
Helena MT 59604-4639
International Fuel Tax Agreement (IFTA)
(406) 444-2998
MDT-IFTA-002
Rev. 11/18
New Carrier Application
Page 2 of 2
Proof of Residency (Three Types)
To establish Residence in a Member Jurisdiction, an Applicant must demonstrate to the satisfaction of the
Member Jurisdiction at least three of the following:
1. A Montana driver's license if the applicant is an individual.
2. If the Applicant is a corporation registered to conduct business as a foreign corporation in Montana.
3. If the Applicant is a corporation & the principal owner is a Montana resident.
4. Proof the Applicant's federal income tax returns have been filed from an address in Montana.
5. Proof the Applicant has paid personal income taxes in Montana.
6. Proof the Applicant has paid real estate or personal property taxes in Montana.
7. Copy of a Montana utility bill in the applicants name.
8. A vehicle titled in Montana in the applicant's name.
9. Registered with Montana Secretary of State.
Page of 2