Form Il-1000-E - Certificate Of Exemption For Pass-Through Entity Payments
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lllinois Department of Revenue
Certifi cate of Exemption for Pass-through
Form IL-1000-E
Entity Payments
Read this information fi rst
Pass-through entities:
In order to accept Form IL-1000-E, make sure that the certifi cate is
Owners:
completed and signed by the owner, offi cer, fi duciary, or authorized
Form IL-1000-E, Certifi cate of Exemption for Pass-through Entity
representative. Keep the certifi cates in your fi les. Do not send them
Payments, should be completed by any owner (partner,
to the department unless we specifi cally request them from you.
shareholder, or benefi ciary) that elects to make their own tax
payments on business income from a pass-through entity
In the event that we notify you that the certifi cate has been revoked,
(partnership, shareholder, or fi duciary). Individuals may not make
the certifi cate remains valid for 60 days after the date of notifi cation,
the exemption election.
and you must then begin withholding for business income distribut-
Specifi c information:
able to the owner.
Form IL-1000-E must only be completed, signed, and submitted
If the certifi cate has been revoked, you may not accept another
once to the pass-through entity. It does not need to be resubmit-
certifi cate from the owner until we notify you.
ted on an annual basis. Do not send Form IL-1000-E to the
department
unless we specifi cally request it from you.
Step 1: Identify the pass-through entity
The pass-through entity must keep this certifi cate.
( _______ ) ______________________________________
______________________________________________________
Name
Phone number
Federal employer identifi cation number (FEIN)
______________________________________________________
Mailing address
____________________________________________________
__
____ ____ - ____ ____ ____ ____ ____ ____ ____
City
State
ZIP
Step 2: Identify the owner (partner, shareholder, or benefi ciary)
Federal employer identifi cation number (FEIN)
_____________________________________________________
Name
_______
_____________________________________________
____ ____ - ____ ____ ____ ____ ____ ____ ____
Mailing address
Check the box to indicate your business type:
___________________________________________________
__
City
State
ZIP
Corporation
Subchapter S corporation
( _______ ) ______________________________________
Partnership
Phone number
Trust
Estate
Step 3: Sign below
I certify that the owner indicated in Step 2 will fi le all Illinois income tax returns and make timely payment of all Illinois income
taxes due, and that it is subject to personal jurisdiction of the State of Illinois for purposes of the collection of income taxes due
with respect to income from the partnership, corporation or trust indicated in Step 1 of this certifi cate.
___________________________________________________________________________________ __ __/__ __/__ __ __ __
Signature of owner, offi cer, fi duciary, or authorized representative
Date
___________________________________________________________________________________ ____________________
Title
Printed name
This form is authorized as outlined by the Registration and Licensing Division and has been approved by the Forms Management Center.
IL-492-4557
IL-1000-E (R-12/09)
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Parent category: Financial