Form Il-1000-E - Certificate Of Exemption For Pass-Through Entity Payments
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Illinois Department of Revenue
Certificate of Exemption for Pass-through
Form IL-1000-E
Entity Payments
Read this information first
Pass-through entities:
In order to accept Form IL-1000-E, make sure that the certificate is
Owners:
completed and signed by the owner, officer, fiduciary, or authorized
Form IL-1000-E, Certificate of Exemption for Pass-through Entity
representative. Keep the certificates in your files. Do not send them
Payments, should be completed by any owner (partner,
to the department unless we specifically request them from you.
shareholder, or beneficiary) that elects to make their own tax
payments on business income from a pass-through entity
In the event that we notify you that the certificate has been revoked,
(partnership, shareholder, or fiduciary). Individuals may not make
the certificate remains valid for 60 days after the date of notification,
the exemption election.
and you must then begin withholding for business income distribut-
Specific information:
able to the owner.
Form IL-1000-E must only be completed, signed, and submitted
If the certificate has been revoked, you may not accept another
once to the pass-through entity. It does not need to be resubmit-
certificate from the owner until we notify you.
ted on an annual basis. Do not send Form IL-1000-E to the
department
unless we specifically request it from you.
Step 1: Identify the pass-through entity
The pass-through entity must keep this certificate.
( _______ ) ______________________________________
______________________________________________________
Name
Phone number
Federal employer identification number (FEIN)
______________________________________________________
Mailing address
____________________________________________________
__
____ ____ - ____ ____ ____ ____ ____ ____ ____
City
State
ZIP
Step 2: Identify the owner (partner, shareholder, or beneficiary)
Federal employer identification number (FEIN)
_____________________________________________________
Name
_______
_____________________________________________
____ ____ - ____ ____ ____ ____ ____ ____ ____
Mailing address
Check the box to indicate your business type:
___________________________________________________
__
City
State
ZIP
Corporation
Subchapter S corporation
( _______ ) ______________________________________
Partnership
Phone number
Trust
Estate
Step 3: Sign below
I certify that the owner indicated in Step 2 will file all Illinois income tax returns and make timely payment of all Illinois income
taxes due, and that it is subject to personal jurisdiction of the State of Illinois for purposes of the collection of income taxes due
with respect to income from the partnership, corporation or trust indicated in Step 1 of this certificate.
___________________________________________________________________________________ __ __/__ __/__ __ __ __
Signature of owner, officer, fiduciary, or authorized representative
Date
___________________________________________________________________________________ ____________________
Title
Printed name
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.
IL-1000-E (R-12/11)
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Parent category: Financial