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Illinois Department of Revenue
RUT-50-X
Amended Private Party
Rev 04 Form 108 Station 485
Vehicle Use Tax Transaction
E S ____/____/____
EC RC CA ED NS
Read this information fi rst
Everyone must complete Steps 1, 2, and 4. You must also
Amount you are paying: $ _________________________
complete Step 3 if you are changing fi nancial information.
Make your check payable to “Illinois Department of Revenue.”
Step 1: Identify yourself
(
)
—
1
5
PV number from original return
PV __ __ __ __ __ __ __ __ __
Daytime telephone number ______________________________
2
6
Your name
__________________________________________
SSN
___ ___ ___ — ___ ___ — ___ ___ ___ ___
Social Security number
3
Co-owner’s name
____________________________________
or FEIN ___ ___ — ___ ___ ___ ___ ___ ___ ___
Federal employer identifi cation number
4
7
Your address from original return
Driver’s license number
__ __ __ __ - __ __ __ __ - __ __ __ __
__________________________________________________
Number and street
__________________________________________________
City
State
ZIP
Step 2: Mark the reason why you are fi ling an amended return
(See instructions.)
1
5
____ I put the incorrect purchase date on my original return.
____ I should have marked one of the $15 exceptions because I
The purchase date should have been
qualify for the following reason
(check one).
__ __/__ __/__ __ __ __.
a
____ Estate gift for benefi ciary (not surviving spouse)
Month
Day
Year
b
____ Business reorganization
2
____ I have returned the vehicle and the deal was cancelled.
c
____ Transferred or purchased from spouse, parent,
Attach proof.
brother, sister, or child (circle one)
3
____ The seller’s name, seller’s address, or vehicle description
6
____ I reported the purchase incorrectly as a motor vehicle
(i.e., year, make, model, odometer reading, or VIN, ) is
but it is actually a motorcycle or an ATV - $25 exception.
incorrect. The correct information is
Name: _________________________________________
7
____ I fi gured the incorrect tax due amount from Table A or Table
Address: _______________________________________
B, or I used the incorrect table to fi gure the tax due amount.
Year:
_________________________________________
The original purchase price of the vehicle is
Make: _________________________________________
$____________________________________________
Attach proof of purchase price
Model: _________________________________________
Odometer reading: _______________________________
VIN: ____________________________________________
8
____ Other. Please explain. ____________________________
_____________________________________________
4
____ I should have marked one of the exemptions because I
_____________________________________________
qualify for the following reason
(check one).
_____________________________________________
a
____ Organization with tax-exempt status - Provide
_____________________________________________
exemption number: E-__
_______________________
_____________________________________________
b
____ Farm implement, or ready-mix concrete truck
_____________________________________________
c
____ Rolling stock - Provide certifi cate of authority
_____________________________________________
number: ______________
_____________________________________________
d
____ You were an out-of-state resident and the item
_____________________________________________
was used outside IL for at least three months.
_____________________________________________
e
____ Estate gift for surviving spouse
Please turn page to complete Steps 3 and 4.
This form is authorized by the Vehicle Use Tax Act. Disclosure of this information is REQUIRED. Failure to provide information
could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-0012
RUT-50-X (R-9/10)
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