Form Cbs-1 - Notice Of Sale Or Purchase Of Business Assets

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Illinois Department of Revenue
CBS-1
Notice of Sale or Purchase of Business Assets
General information
You (or the purchaser or the transferee) must complete this form if,
If you need additional information, you may call our Chicago office
weekdays between 8:30 a.m. and 5:00 p.m. at 312 814-3063.
outside your usual course of business, you sell or transfer the major
part of
Mail your completed form and a copy of the sales contract and
financing agreement to:
the stock of goods that you are in the business of selling,
the furniture or fixtures,
BULK SALES UNIT
the machinery and equipment, or
ILLINOIS DEPARTMENT OF REVENUE
the real property of your business.
100 WEST RANDOLPH LEVEL 7-400
CHICAGO IL 60601
Forms received more than 10 days after the sale date will not be
processed. The purchaser may be held liable for any debt incurred by
You may fax your form and sales contract to us at 312 793-3841.
the seller.
Part 1: Identify the business being sold and the registration numbers
___ ___ ___ ___ ___ ___ ___ ___
3
1 ____________________________________________________
Business name
Illinois business tax number (IBT no.)
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
2
4
____________________________________________________
Street address
Federal employer identification number (FEIN)
Seq. number
___ ___ ___ ___ ___ ___ ___ ___ ___
5
____________________________________________________
Street address (if needed)
Social Security number
6
Are you required to pay any excise taxes ?
____________________________________________________
Yes
No
City
State
ZIP
Excise tax number ________________________________________
Part 2: Identify the seller
(
)
7
9
____________________________________________________
__________________________
Seller’s name
Seller’s daytime phone number
(
)
8
10
____________________________________________________
____________________________________________________
Seller’s home or mailing address
Name of seller’s attorney
Daytime phone number
11
____________________________________________________
____________________________________________________
City
State
ZIP
Address of seller’s attorney
Part 3: Identify the purchaser
12
14
____________________________________________________
____________________________________________________
Purchaser’s name
Purchaser’s IBT no. and FEIN
(
)
13
15
____________________________________________________
____________________________________________________
Purchaser’s home or mailing address
Name of purchaser’s attorney
Daytime phone number
16
____________________________________________________
____________________________________________________
City
State
ZIP
Address of purchaser’s attorney
Part 4: Describe the terms of sale
_____ _____ _____
17
21
Date business was sold or is to be sold.
Terms of sale. Write an “X” in the appropriate box, and provide
additional information as requested.
Month
Day
Year
18
Write the selling price of the business. $ ____________________
Cash sale
19
Was the entire business sold?
Contract sale. Complete the following information:
Yes
Amount of down payment
$ ____________________
No (If “No,” you must complete Line 20.)
Amount of monthly payment
$ ____________________
_____ _____ _____
20
Are the seller’s registration numbers with the department to
Date last payment is due
Month
Day
Year
remain active?
Yes
Conventional financing
No (If “No,” write the date to be discontinued.)
Other (specify) _____________________________________
_____ _____ _____
Effective date
__________________________________________________
Month
Day
Year
__________________________________________________
Part 5: Sign below
(
)
22
24
____________________________________________________
____________________________________________________
Signature of person submitting this form
Date
Print or type the name of person submitting this form
Daytime phone number
23
____________________________________________________
Mailing address of person submitting this form
____________________________________________________
City
State
ZIP
This form is authorized as outlined by the Illinois Income Tax Act [35 ILCS 5/902] and the Retailers' Occupation Tax Act [35 ILCS 120/5j]. You are required to report all sales of
businesses to the Illinois Department of Revenue. Disclosure of this information is REQUIRED. Failure to provide such information may result in the purchaser or transferee
becoming personally liable for the amount of tax owed by the seller. This form has been approved by the Forms Management Center.
IL-492-4224
CBS-1 (R-10/06)
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