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Illinois Department of Revenue
ST-4-X
Amended Metropolitan Pier and Exposition
Authority Food and Beverage Tax Return
Rev 02 Form 038
E S __ __/__ __/__ __ __ __
NS
DP
CA
RC
Do not write above this line.
Read this information fi rst
•
If you are making a payment with this return,
$___________________________
write the amount you are paying here.
Make your check payable to “Illinois Department of Revenue.”
•
If you are claiming an overpayment on this return and you collected the overpaid tax from your customer(s), you must re-
fund the tax to your customer(s) before fi ling this return. When you complete this return, you must state, under penalties of
perjury, in Step 4, that you unconditionally refunded the overpaid tax to your customer(s).
Step 1: Identify your business
1
Account ID: ____ ____ ____ ____ - ____ ____ ____ ____
2
Reporting period you are amending:
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Month Day
Year
Month Day
Year
3
Business name _______________________________________
Step 2: Mark the reason you are fi ling an amended return
1
3
_____
I took a deduction on my original return that was not
_____
I put an amount on the wrong line on either Form ST-4
allowed or was too large.
or Form ST-7.
2
_____
I should have taken a deduction or a larger deduction
4
on my original return because I sold food and beverages
_____
I overcollected the MPEA Food and Beverage Tax
from my customer.
a
_____
to another Illinois business for resale. Write
5
the business’ account ID _______________.
_____
I made a computational error.
b
_____
to an out-of-state customer, and the sale was
6
in interstate commerce. The merchandise
_____
The original account ID was incorrect. The correct
was delivered to a location outside Illinois.
account ID is __________________________________.
c
_____
to an exempt organization. Write the tax-
7
exempt no. E-________________________.
_____
The original reporting period was incorrect. The correct
d
_____
that were returned by my customer.
reporting period is ______________________________.
e
8
_____
that were exempt for another reason.
_____
Other. (Please explain.) __________________________
Please explain. _______________________
_____________________________________________
____________________________________
_____________________________________________
____________________________________
_____________________________________________
Please turn page to complete Steps 3 and 4.
This form is authorized by the Metropolitan Pier and Exposition Authority 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-492-3210
*003821110*
ST-4-X front (R-1/10)