Form Rhm-1-X - Amended Hotel Operators' Occupation Tax Return
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Illinois Department of Revenue
REV 2
Form 477
RHM-1-X
E S ___/___/___
Amended Hotel Operators' Occupation Tax Return
NS
DP
CA
Station no. 517
Do not write above this line.
Identify your business
Account ID:___ ___ ___ ___ ___ ___ ___ ___
Check here if your address has changed.
Tell us the liability period for which you are filing this return:
HM -
License no.
___ ___ ___ ___ ___
Month of: __ __/___ __
Quarter ending: __ __/___ __
Business name
_______________________________________
Year: __ __ __ __
Business address ________________________________________
Is this a final return (you are no longer in business)?
yes
no
Number and street
___________________________________________________
City
State
ZIP
Step 1: Figure your taxable base -
Figures as they should have been filed
1
1
Total receipts. (Includes all room rental receipts, state, and local tax collected for this reporting period.)
______________|____
2
2
Local tax deduction
______________|____
3
3
Permanent resident deduction
______________|____
4
Other deductions (Describe each deduction by item and amount on the lines below)
Example: foreign diplomats: $1,000.00, meeting rooms: $200.00
_________________________________________________________________
_________________________________________________________________
Total other deductions: 4
_________________________________________________________________
______________|____
5
Subtraction for MPEA Hotel Tax collected.
5
______________|____
6
Add Lines 2 through 5. This is your total deductions.
6
______________|____
7
Subtract Line 6 from Line 1. This is your taxable base.
7
______________|____
Step 2: Figure your total tax -
Figures as they should have been filed
8
State tax. Multiply Line 7 by .0564
8
______________|____
9
Chicago taxes. Multiply Line 7 by .05235
9
______________|____
10 Add Lines 8 and 9. This is your total tax.
10 ______________|____
Step 3: Figure your discount -
Figures as they should have been filed
11 If you file and pay on time, multiply Line 10 by .021
11 ______________|____
Step 4: Figure your payment due -
Figures as they should have been filed
12 Subtract Line 11 from Line 10. This is your net tax due.
12 ______________|____
13 If you collected too much tax, report the amount of excess tax you collected.
13 ______________|____
14 Add Line 12 and Line 13. This is your tax due.
14 ______________|____
15 Credit you wish to apply.
15 ______________|____
16 Subtract Line 15 from Line 14. This is your net tax due.
16 ______________|____
17 Total amount you paid for this reporting period.
17 ______________|____
18 If Line 17 is greater than Line 16, figure your overpayment by subtracting Line 16 from Line 17.
18 ______________|____
19 If Line 17 is less than Line 16, figure your underpayment by subtracting Line 17 from Line 16.
19 ______________|____
Pay this amount and make your check payable to “Illinois Department of Revenue.”
Step 5: Check the reason you are filing this amended return
I received a Notice of Possible Overpayment or made a computation error that resulted in an overpayment of tax.
• If you checked this box, did you collect the overpaid tax from your customer?
yes
no
• If you checked “yes,” did you unconditionally refund the overpaid tax?
yes
no
I made a computation error that resulted in underpayment of tax.
I made an error on a schedule or attachment.
I should have taken a deduction for ________________________________________________________________________________
The original License no. was incorrect. The incorrect License no. is HM-__ __ __ __ __.
The original reporting period was incorrect. The incorrect reporting period is ___________________________.
Other. Please explain. ___________________________________________________________________________________________
Step 6: Sign below
Under penalties of perjury, I state that I have examined this return and, to the best of my knowledge, it is true, correct, and complete. The
information in this return is taken from the records of the business for which it is filed.
___________________________________________________
____________
____/____/________ (____)____-____________
Taxpayer's signature
Title
Date
Telephone (Include area code)
___________________________________________________
____/____/________ (____)____-____________
Preparer's signature
Date
Telephone (Include area code)
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed.
*347721110*
Disclosure of this information is required. Failure to provide information may result in this form not being processed and
RHM-1X (R-05/13)
may result in a penalty.
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