Rpu-50 Quarter-Monthly Payment Form

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Illinois Department of Revenue
RPU-50
Quarter-Monthly Payment - [Gas, Telecommunications, Electric]
(R-12/00)
Station no. : ###
Mail this card and payment to:
Illinois business tax no. : ####-####
ILLINOIS DEPARTMENT OF REVENUE
License no. : X-####
PO BOX 19019
Liability period : ##/####
Your quarter-monthly tax payment due
SPRINGFIELD IL 62794-9019
dates are:
Please pay
$#############
<month day, year>; <month day, year>;
or 22.5% of your actual liability
<month day, year>; and <month day, year>.
due for the current month.
1. Credit applied
$_______________________________
NAME
Attach original credit memorandum
ADDRESS
2. Check amount
$_______________________________
ADDRESS
3. Total paid
$_______________________________
CITY STATE ZIP
_______________________________
Official use
RPU50 1100 00668753 07 0030 1 0000000000000

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