Joliet Food And Beverage Tax Return Form - 2010
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Statement of Tax Receipts under the provisions of
JOLIET FOOD AND BEVERAGE
Ordinance No. 9166, 7650 and 13001(Chapter 28, Articles 8
TAX RETURN
and 17 of City Code of Ordinances).
Local business name, address and telephone number in
CITY OF JOLIET
Joliet
Department of Management & Budget
Business Services
_____________________________________________
150 West Jefferson Street
Joliet, Illinois 60432
_____________________________________________
Phone - 815.724.3905 Fax - 815.724.3904
E-mail -
_____________________________________________
If the business has been closed, sold to a new entity or
no longer incurs liability for taxes to the City of Joliet,
TAX RETURN
please complete the following:
FOR MONTH OF
________________________
Date of Final Tax Return: _______________________
Illinois State Tax Number (IBT)
Date Business Closed: _________________________
-
- __________
Date Business Sold: ___________________________
Old/Closing owner information:
COMPUTATION OF TAXES – food/beverage
Name: ______________________________________
1) Total food/beverage tax collected
______________
Address: ____________________________________
2) Total Gross Receipts from the
____________________________________
Taxable purchase of food &
Beverage items, EXCLUSIVE
Telephone No. _______________________________
OF ANY TAXES
______________
New Owner Information:
3) Computed food & beverage
Name: ______________________________________
Tax (line 2 x 1% or 0.01)
______________
4) Late filing interest 2% per
Address: ____________________________________
month (line 3 x 2% or 0.02)
______________
____________________________________
5
) Late filing penalty 5%
Telephone No. _______________________________
(line 3 x 5% or 0.05)
______________
6) Late payment penalty 5%
(line 3 x 5% or 0.05)
______________
TO PAY BY VISA OR MASTERCARD:
7) Total amount due
______________
Mastercard _____
VISA _____
(sum of lines 3 – 6)
Account No.______ -______ - ______ - ______
Taxes are due at the City of Joliet offices no later than
Expiration Date: _____/_____
the last day of the following month.
Billing Address on account:
Under penalties provided by Ordinance, the undersigned certifies
_______________________________________
that this return is true and accurate and is taken from the books
and records of the business for which the return is filed.
_______________________________________
Name: ____________________________________________
_______________________________________
Address: __________________________________________
Signature
___________________________________________
MAKE CHECKS PAYABLE TO: CITY OF JOLIET
Telephone No: _____________________________________
MAIL TO:
City Collector - Taxes
City of Joliet
_______________________________
______________
150 West Jefferson Street
Signature
Date
Joliet, IL 60432
08/19/2010 i:gundersen/1business/forms/foodandb.doc
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