Montana Film Production Credit - Submission of Costs - End of Principal Photography (OBSOLETE)

Film Production Credit - Submission of Costs - End of Principal Photography (OBSOLETE)
Form FPC-PP
CLEAR FORM

Film Production Credit
Residency Declaration

MONTANA
FPC-RD
Rev 01 12

What is the purpose of this form?
A film production company claiming the employment production credit based on wages or salaries paid to Montana
residents for work performed on a film produced in Montana is required to have each employee complete a residency
declaration form. This form is not required to be submitted to the Department of Revenue, but is required to be retained by
the production company as a tax record and provided to the Department of Revenue upon request.
Name

Social Security Number

-

-

Address (enter your physical Montana address – this cannot be a post office box number)

City

State

Zip Code

Title of Film Project

Telephone Number

Montana Film Certification Number

	 3.	

	 Yes	
	 No
Are you presently a resident of Montana? See Residency below.	
Do you anticipate changing your residency status during the time
you are expected to work on the film project?	
	 Yes	
	 No
What evidence have you provided the film production company to show residency in Montana?

	

	

	 1.	
	 2.	

	

A valid Montana driver’s license.
Enter your driver’s license number here.________________________________________

	
	

	

A current Montana voter registration card.
Enter the registering county name here.________________________________________

	

	
	

A copy of last year’s Montana individual income tax return.

	

	

Other: If you cannot provide one of the previous three forms, other evidence may be acceptable. For
example, a minor may present his or her parent’s proof of residency. Other evidence should be clear
and convincing, and show intent to maintain a permanent residence in Montana. Proof of ownership
of property or establishing an abode in Montana is not acceptable unless it is supplemented by other
information showing intent.
Please specify:___________________________________________________________

Residency. To be a resident of Montana for tax purposes, you are required to be domiciled in Montana. Your domicile is
your permanent home; it is the place to which you intend to return after any temporary absence. You can have only one
domicile. A change in domicile is established only by establishing a physical presence in a new location with intent to
abandon your old domicile and make a home in the new location permanently or indefinitely.
By signing and dating this form, the undersigned is attesting that the information contained in this declaration is true and
correct.

__________________________________________________	
	
Signature	
Questions? Call toll free (866) 859-2254 (in Helena, 444-6900).

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Date