Form Il-700-H - Illinois Household Employer'S Tax Return
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1Illinois Department of Revenue
IL-700-H
Illinois Household Employer’s Tax Return
for calendar year __ __ __ __ or fiscal year ending __ __ /__ __/ __ __ __ __
Month
Day
Year
Station 369
Who must file?
What if I need additional assistance?
You must file Form IL-700-H if you withhold Illinois Income Tax
If you need additional assistance, visit our web site at
from your household employee’s wages and elect to file and
, call our Taxpayer Assistance Division at
pay once a year.
1 800 732-8866 or 217 782-3336, or call our TDD (telecom-
munications device for the deaf) at 1 800 544-5304. Our office
When must I file and pay?
hours are 8 a.m. to 5 p.m.
You must file Form IL-700-H and pay the tax you withheld from
your household employee’s compensation on or before the
15th day of the 4th month following the close of your tax year.
For most taxpayers, this is April 15.
Step 1: Identify yourself and your spouse
1 ___ ___ ___ - ___ ___ - ___ ___ ___ ___
___ ___ ___ - ___ ___ - ___ ___ ___ ___
Your Social Security number (SSN)
Your spouse’s Social Security number (SSN)
2 _______________________________________________
_______________________________________________
Household employer’s name
Spouse’s name
3 _______________________________________________
Street address
4 _______________________________________________
City
State
ZIP
Step 2: Identify your household employees and list the Illinois Income Tax that
you withheld for each
Column A
Column B
Column C
Column D
Household
Household
Household
Illinois Income Tax withheld from
employee’s name
employee’s SSN
employee’s wages
household employee’s wages
5 _______________________
$______________________ $______________________
___ ___ ___-___ ___-___ ___ ___ ___
6 _______________________
$______________________ $______________________
___ ___ ___-___ ___-___ ___ ___ ___
7 _______________________
$______________________ $______________________
___ ___ ___-___ ___-___ ___ ___ ___
8 _______________________
$______________________ $______________________
___ ___ ___-___ ___-___ ___ ___ ___
9 _______________________
$______________________ $______________________
___ ___ ___-___ ___-___ ___ ___ ___
Note: If you need additional space, please attach a sheet of paper using the same format.
10
10 _______________________
Write the total amount of Column D. This is your tax due. Pay this amount.
Make your payment to “Illinois Department of Revenue.” You must write your SSN
and the form number “IL-700-H” on your payment.
Step 3: Sign below
Under penalties of perjury, I state that I have examined this form and, to the best of my knowledge, it is true, correct, and complete.
(
)
-
_____________________________________________________________________
_______________________
Household employer’s signature (full name)
Date
Daytime telephone number
___ ___ - ___ ___ ___ ___ ___ ___ ___
Federal employer identification number (FEIN)
Step 4: Mail to
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19025
SPRINGFIELD IL 62794-9025
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-492-3745
IL-700-H (R-12/04)
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