Form Il-941-X - Amended Illinois Withholding Income Tax Return And Instructions - 2012

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Illinois Department of Revenue
Form IL-941-X
2012
Amended Illinois Withholding Income Tax Return and Instructions
Step 1: Provide your information
Reporting Period
_ __ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___
If you are a quarterly filer:
Seq. number
F ederal employer identification number (FEIN)
Check the quarter you are amending.
Check this
____________________________________________________________
1st
(January, February, March)
box if your
B usiness name
business
2nd
(April, May, June)
name has
____________________________________________________________
changed.
C/O
3rd
(July, August, September)
Check this
_ ___________________________________________________________
4th
box i f you
(October, November, December)
M ailing address
have an
If you are an annual filer:
address
_ _____________________________ _______ __________________
change.
Check the box if you are amending an annual return.
City
State
ZIP
January — December
Step 2: Tell us about your business
A
If your business has permanently stopped withholding because it has closed or you
A
no longer pay wages, check the box and write the date you stopped paying wages.
__ __ / __ __ / 2012
Month Day
Step 3: Tell us your payroll information
Column A
Column B
Most recent amount reported
Corrected amount
1
Write the total compensation and gambling winnings (including Illinois Lottery
1
__________________
1
__________________
winnings) subject to withholding this period.
Step 4: Tell us your withholding and previous overpayments
2
2 __________________ 2 __________________
Write the amount of Illinois Income Tax actually withheld for this period.
3
Write the total of all previous refunds, credits carried forward, and
overpayments you reported on your original return or previously filed
3 __________________ 3 __________________
IL-941-X (whether or not you received it).
4
4 __________________ 4 __________________
Add Column B, Lines 2 and 3 and write the total amount here.
Step 5: Tell us about your payments and credits
5
Write the total amount of withholding payments you have made during this
period. This includes all IL-501 payments (electronic and paper coupons), as
5 __________________ 5 __________________
well as any subsequent payments. Do not include any penalty or interest paid.
6
6 __________________ 6 __________________
Write the amount of any credit carried forward from your previous Form IL-941.
7
7 __________________ 7 __________________
Write the total amount of credits you have received through DCEO.
8
8
__________________ 8
__________________
Add Lines 5 through 7 and write the total amounts here.
Step 6: Figure your credit or the amount you owe
9
If Line 4 is greater than Column B, Line 8, subtract Column B, Line 8 from Line 4. This is your remaining
balance due. Make your payment electronically (semi-weeklys must pay electronically) or your
9 __________________
remittance payable to “Illinois Department of Revenue” and go to Step 7.
10
If Line 4 is less than Column B, Line 8, subtract Line 4 from Column B, Line 8. This is your overpayment.
10_________________
Note: Your overpayment will first be applied to any unpaid Illinois withholding tax liability.
11
Check the appropriate box to tell us what to do with your overpayment.
Credit
Refund
You must explain the reason for your overpayment below.
Explanation ___________________________________________________________________________________________________
______________________________________________________________________________________________________________
Step 7: Sign here
Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete.
______________________________________________ (____)________________
__ __ / __ __ / __ __ __ __
Signature
Daytime telephone number
Month Day
Year
Mail to:
NSX DRX
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19007
*270701110*
SPRINGFIELD IL 62794-9007
IL-941-X (R-12/11)
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