Form Il-843 - Amended Return Or Notice Of Change In Income - 2006
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Illinois Department of Revenue
IL-843
Amended Return or Notice of Change in Income
Attach to your revised Form IL-1041, IL-1023-C, or IL-990-T.
.
.
Check one:
For calendar year
__ __ __ __
Other year beginning
__ __/__ __/__ __ __ __
, and ending
__ __/__ __/__ __ __ __
Part 1: Provide the following information
1
Print or type your name, current address, FEIN, and IBT.
___________________________________________________
|____|____| - |____|____|____|____|____|____|____|
Name
Federal employer identification number (FEIN)
|____|____|____|____| - |____|____|____|____|
__________________________________________________________
In care of
Illinois business tax (IBT) number
3
___________________________________________________
Check the appropriate box for the type of change being made.
Mailing address
NOL
State change
__________________________________________________________
Federal change
—
Partial agreed
Finalized
City
State
ZIP
2
Check the box if any of the above information is new.
Write the date of IRS finalization. __ __/ __ __/ __ __ __ __
Check the box if you are filing this form only to report
Month
Day
Year
an increased net loss (see instructions).
4
Explain, in detail, why you are filing this form.
5
Check the type of Illinois return you originally filed.
Form IL-1041 —
Trust or
Estate
Form IL-1023-C
Form IL-990-T —
Corporation or
Trust
You must attach a revised copy of the appropriate Illinois return and any required schedules.
Complete Part 2 if you are reporting a change in federal ordinary or taxable income; otherwise go to Part 3.
Part 2: Report changes in your federal ordinary or taxable income
6 Write your taxable income from U.S. Form 1041 or U.S. Form 990-T as most recently reported
or adjusted. Refer to Form IL-1041 or Form IL-990-T, Part I, Line 1, specific instructions
for the year being amended.
6 ______________|___
7 Write your corrected income.
7 ______________|___
8 Subtract Line 6 from Line 7. This is your net change.
8 ______________|___
Part 3: Figure your refund or balance due
9
9
Write the tax withheld. Attach Form W-2 (fiduciaries only).
_______________|____
10
10
Write the estimated payments and/or payments made with Form IL-505-B.
_______________|____
11
11
Write the tax paid with your original return (do not include penalty and interest).
_______________|____
12
12
Write any subsequent tax payments (do not include penalty and interest).
_______________|____
13
13
Add Lines 9 through 12. This is your total tax paid.
_______________|____
14
14
Write the total amounts previously refunded and/or credited for the year being amended.
_______________|____
15
15
Subtract Line 14 from Line 13. This is your net tax paid.
_______________|____
16
16
Write the corrected net tax (not less than zero) after recapture and tax credits.
_______________|____
17
17
Refund. Subtract Line 16 from Line 15.
_______________|____
18
18
Tax due. Subtract Line 15 from Line 16.
_______________|____
19
19
Penalty and interest due (see instructions).
_______________|____
20
20
Total balance due. Add Lines 18 and 19. Pay in full if $1 or more. (See instructions.)
_______________|____
Under penalties of perjury, I state that I have examined this return and, to the best of my knowledge, it is true, correct,
Do not write in this box.
and complete.
Sign
_______________________________________________________/_____/______
________________________
(____)_____________
Signature
Date
Title
Phone
Check if self-
here
_______________________________________________________/____/_______
_______________________________
employed
Signature of preparer
Date
Preparer’s SSN, FEIN, or PTIN
______________________________________
______________________________________________________
(____)_____________
Preparer firm’s name (or yours, if self-employed)
Address
Phone
Mail this return to: Illinois Department of Revenue, P.O. Box 19016, Springfield, IL 62794-9016
This form is authorized as outlined by the Illinois Income 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-492-0077
Page 1 of 4
IL-843 (R-12/06)
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