Montana Beer Connoisseurs Semi-Annual Tax Report — Return and Instructions (Form BCT, combo)

LCD 48

Beer Connoisseur's License Application
V3 1/2022
Clear Form
Section 1 - Required Fees and License Information
Beer $50
Please enclose a copy of one of the documents below for proof of age and mark the appropriate box:
Copy of birth certificate
Section 2 - General Information
Driver's license Other state-issued identification
Applicant Name____
Mailing Address____
Street Address or PO Box City State Zip
Shipping Address_ __
Number and Street City State Zip
Note: Beer cannot be shipped to post office boxes.
Email Address____
Yes, I would prefer to receive an annual reminder email to complete my renewal electronically.

Social Security Number
Section 3 - Questions
Telephone Number____
Do you agree to provide semi-annual (June 30 and December 31) reports to the Department of Revenue showing the quantity of beer you received by direct shipment and pay applicable taxes due?
Yes No
Do you agree to comply with all Montana laws and all Department of Revenue rules and regulations pertaining to the shipping of products? (Refer to 16-4-901; 16-4-902; 16-4-903; 16-4-910 and 16-6-301, MCA.) Yes No Section 4 - Declaration and Affidavit This application is made for the purpose of licensing the above-mentioned connoisseur.
Montana law states "upon proof that any applicant made false statements in any part of the application, the application for license may be denied, and if issued the license may be revoked" (16-4-402, MCA).
I declare under penalty of false swearing that I am the applicant or the duly authorized representative of the individual making this application, and that the responses provided, including any accompanying information, are true, correct and complete.
Applicant Signature_Date __
Print Name_ __
Please return this application to:
Alcoholic Beverage Control Division
PO Box 1712
Helena, MT 59624-1712
Questions? Call us at (406) 444-6900, or

Montana Relay at 711 for the hearing impaired.
13MM0101
13MM0101