Form St-49 - Application For Expanded Temporary Storage Permit - 2003 Page 2
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1
2Line 6 - Write your company’s Illinois business tax (IBT)
Line-by-Line Instructions
number.
Part 1: Applicant information
Line 7 - Write the name and daytime telephone number,
Line 1 - Write your company’s legal name.
including area code, of your contact representative. We may
need to contact you about this application.
Line 2 - If, for business purposes, your company is using any
name other than the name on Line 1, write that name on this
Part 2: Applicant’s signature
line.
The authorized officer or individual must provide the informa-
tion in Part 2, and sign this form.
Line 3 - Write the address of the physical location of your
business.
Mail your completed form to:
Line 4 - Write your mailing address, if it is different from the
CENTRAL REGISTRATION DIVISION
business address on Line 3.
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19030
Line 5 - Write your company’s federal employer identification
SPRINGFIELD IL 62794-9030
number (FEIN).
ST-49 back (R-01/03)
IL-492-4279
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Parent category: Financial