Part 4: Correct your financial information
Column A
Column B
Most recent figures filed
Figures as they should
have been filed
When writing your figures please round to the nearest whole dollar.
1
Write the total gallons you sold.
1
1
______________
______________
2
Write the deductible gallons you sold
a
to exempt organizations.
2a ______________
2a ______________
b
for other reasons. (Please identify.) ______________
2b ______________
2b ______________
3
Add Line 2a and Line 2b.
The sum is the total deductible gallons.
3 ______________
3 ______________
4
Subtract Line 3 from Line 1.
The difference is the taxable gallons.
4 ______________
4 ______________
5
Multiply Line 4 by the applicable tax rate.
This is the tax due on taxable gallons.
5 ______________
5 ______________
6
Discount (See note.)
6 ______________
6 ______________
7
Subtract Line 6 from Line 5.
This is the net tax due on taxable gallons.
7 ______________
7 ______________
8
Write any prior overpayment amount you are using.
8 ______________
8 ______________
9
Subtract Line 8 from Line 7. This is the net tax due.
9 ______________
9 ______________
10
Penalty (See instructions.)
10 ______________
10 ______________
11
Interest (See instructions.)
11 ______________
11 ______________
12
Add Line 10 and Line 11.
This is the total penalty and interest.
12 ______________
12 ______________
13
Add Line 9 and Line 12.
This is the total tax, penalty, and interest.
13 ______________
13 ______________
14
Write any credit memorandum amount you are using.
14 ______________
14 ______________
15
Subtract Line 14 from Line 13. This is the net total due.
15 ______________
15 ______________
16
Write the total amount you have paid.
16 ______________
17
If Line 16 is greater than Line 15, Column B, subtract Line 15, Column B,
from Line 16. This is the amount you have overpaid.
Stop here, and sign this return in Part 5.
17 ______________
18
If Line 16 is less than Line 15, Column B, subtract Line 16
from Line 15, Column B. This is the amount you have underpaid.
Please pay this amount. Sign this return in Part 5.
18 ______________
Make your check payable to “Illinois Department of Revenue.”
Please write the amount you are paying on the line provided on the front of this return.
Part 5: Sign below
Under penalties of perjury, I state that I have examined this return and, to the best of my knowledge, it is true, correct, and complete.
(
)
-
________________________________________________________________________________________________________________
Owner, partner, or officer's signature
Title
Phone
Date
(
)
-
________________________________________________________________________________________________________________
Paid preparer's signature
Title
Phone
Date
Mail this return and any payment you owe to:
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19034
SPRINGFIELD IL 62794-9034
CMFT-1-X back (R-1/03)
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