Form Eda-117 - Multiple Location Schedule

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Illinois Department of Revenue
EDA-117
Multiple Location Schedule
REV 01 Form 072
(attach to EDA-98)
IBT number:
Audit period: ______________________________
___ ___ ___ ___ - ___ ___ ___ ___
Write tax amounts only.
1a
GM (pre 1/90)
__________________________
1b
Location code
_________________________________
GM (post 12/89)
__________________________
1c
Food and drug
__________________________
2
Local tax (pre 1/90)
__________________________
3
Site name
_________________________________
Co. sup. tax (pre 1/90)
__________________________
4
Mass transit (pre 1/90)
__________________________
5
Address
_________________________________
CWCT (pre 1/90)
__________________________
7a
Home rule sales tax
__________________________
7b
_________________________________
Home rule use tax
__________________________
8
MPEA tax
__________________________
10a
_________________________________
ART sales tax
__________________________
10c
ART local tax
__________________________
10d
ART MPEA tax
__________________________
1a
GM (pre 1/90)
__________________________
1b
Location code
_________________________________
GM (post 12/89)
__________________________
1c
Food and drug
__________________________
2
Local tax (pre 1/90)
__________________________
3
Site name
_________________________________
Co. sup. tax (pre 1/90)
__________________________
4
Mass transit (pre 1/90)
__________________________
5
Address
_________________________________
CWCT (pre 1/90)
__________________________
7a
Home rule sales tax
__________________________
7b
_________________________________
Home rule use tax
__________________________
8
MPEA tax
__________________________
10a
_________________________________
ART sales tax
__________________________
10c
ART local tax
__________________________
10d
ART MPEA tax
__________________________
1a
GM (pre 1/90)
__________________________
1b
Location code
_________________________________
GM (post 12/89)
__________________________
1c
Food and drug
__________________________
2
Local tax (pre 1/90)
__________________________
3
Site name
_________________________________
Co. sup. tax (pre 1/90)
__________________________
4
Mass transit (pre 1/90)
__________________________
5
Address
_________________________________
CWCT (pre 1/90)
__________________________
7a
Home rule sales tax
__________________________
7b
_________________________________
Home rule use tax
__________________________
8
MPEA tax
__________________________
10a
_________________________________
ART sales tax
__________________________
10c
ART local tax
__________________________
10d
ART MPEA tax
__________________________
1a
GM (pre 1/90)
__________________________
1b
Location code
_________________________________
GM (post 12/89)
__________________________
1c
Food and drug
__________________________
2
Local tax (pre 1/90)
__________________________
3
Site name
_________________________________
Co. sup. tax (pre 1/90)
__________________________
4
Mass transit (pre 1/90)
__________________________
5
Address
_________________________________
CWCT (pre 1/90)
__________________________
7a
Home rule sales tax
__________________________
7b
_________________________________
Home rule use tax
__________________________
8
MPEA tax
__________________________
10a
_________________________________
ART sales tax
__________________________
10c
ART local tax
__________________________
10d
ART MPEA tax
__________________________
Completed by _____________________________________ Date ________________________ Page _______ of _______
____________
___
EDA-117 (R-8/01) IL-492-3718
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