Form St-1-X - Amended Sales And Use Tax Return Form - State Of Illinois - 2001

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Illinois Department of Revenue
ST-1-X
Amended Sales and Use Tax Return
REV 02
FORM 003
E S ____/___/____
NS DP CA RC
Do not write above this line.
Read this information first
Everyone must complete Parts 1, 2, and 5.
You must also complete
Amount you are paying: $ _______________
• Part 3 if you believe you have overpaid, and
Make your check payable to “Illinois Department of Revenue.”
• Part 4 if you are changing financial information.
Part 1: Identify your business
1
IBT no. ______________________________________________
“X” only if your address is different from the address on your
Illinois business tax number
original return and complete item 4 below.
2
4
Amended tax period ___________________________________
Mailing address ______________________________________
Number and street
3
Business name _______________________________________
____________________________________________________
City
State
Zip
Part 2: Check the reason you are correcting your return
1 __
3
__ I took a deduction on my original return that was
____ I put an amount on the wrong line on either
not allowed or was too large.
Form ST-1 or Form ST-2.
2 _
4 _
___ I should have taken a deduction or a larger deduction
___ I overcollected sales tax from my customer.
on my original return because I sold merchandise
a
5 _
____ to another Illinois business for resale.
___ I made a computational error.
(Business’ IBT no. ___________________)
b
6
____ to an out of state customer, which was a sale
____ I paid a higher rate of tax on the sale of food,
in interstate commerce. The merchandise was
drugs, and medical appliances than I should have.
delivered to a location outside Illinois.
c
7
____ to an exempt organization.
____ The original IBT number was incorrect. The
(Tax-exempt no. E- ___________________)
correct IBT number is _____________________________.
d
.
____ that qualified for a tax relief exemption such as
8
machinery or equipment used in manufacturing,
____ The original tax period was incorrect. The correct
farming, graphic arts, ethanol distillation, oil field
tax period is _____________________________________.
exploration (drilling and production), or coal
9
exploration (mining and reclamation).
____ Other: Please explain.
e
____ that qualified for an enterprise zone
_______________________________________________________
exemption.
_______________________________________________________
f
____ that was returned by my customer.
_______________________________________________________
g
____ that was exempt for another reason. Please explain.
_______________________________________________________
_____________________________________________
_______________________________________________________
_____________________________________________
_______________________________________________________
Part 3: If you are claiming an overpayment, you must answer the following
1
Did you collect the overpaid tax from your customer?
_______ yes
_______ no
2
If yes, did you unconditionally refund the overpaid tax?
_______ yes
_______ no
Please turn page over to complete Parts 4 and 5
This form is authorized by the Retailers’ Occupation Tax and related acts. 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-492-2735
ST-1-X Front (R-03/01)

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