Form St-4 - Metropolitan Pier And Exposition Authority Food And Beverage Tax Return

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Illinois Department of Revenue
ST-4
Metropolitan Pier and Exposition Authority
Food and Beverage Tax Return
IBT no.
__ __ __ __ - __ __ __ __
Liability period
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Rev 01
Month
Day
Year
Month
Day
Year
Form 028
Business name _______________________________________________________________________
Stations 701, 702
_ _
_ _
_ _ _ _
/
/
E
S
Address _____________________________________________________________________________
NS
DP
CA
RC
Do not write above this line.
____________________________________________________________________________________
____________________________________________________________________________________
City
State
ZIP
You must round your fi gures to whole dollars. See instructions.
Step 5: Figure your penalty and interest
Step 1: Figure your taxable MPEA receipts
If you fi led after the due date, see instructions.
1
1 ___________________
Total MPEA receipts (include MPEA tax)
9
9 ___________________
Penalty
2
2 ___________________
Deductions (from worksheet on back)
10
10 ___________________
Interest
3
Taxable MPEA receipts
11
Total penalty and interest
3 ___________________
(Subtract Line 2 from Line 1.)
11 ___________________
(Add Lines 9 and 10.)
Step 2: Figure your tax on receipts
Step 6: Figure your payment due
4
MPEA tax due on receipts
12
12 ___________________
Excess MPEA tax collected
4 ___________________
(Multiply Line 3 by 1% (.01).)
13
Total tax, penalty, and interest
Step 3: Figure your discount
13 ___________________
(Add Lines 8,11, and 12.)
14
14 ___________________
Credit memorandum
5
If you fi led and paid by the due date,
15
Payment due
5 ___________________
multiply Line 4 by 1.75% (.0175).
15 ___________________
(Subtract Line 14 from Line 13.)
6
MPEA net tax due on receipts
6 ___________________
Subtract Line 5 from Line 4.
Step 7: Sign below
Under penalties of perjury, I state that I have examined this return and, to the
Step 4: Figure your net tax due
best of my knowledge, it is true, correct and complete.
7
7 ___________________
Prior overpayment
_ _/_ _/_ _ _ _
_______________________________________
8
Net MPEA tax due
Taxpayer’s signature
Phone no.
Date
8 ___________________
(Subtract Line 7 from Line 6.)
_ _/_ _/_ _ _ _
_______________________________________
Preparer’s signature
Phone no.
Date
Write the amount you are paying from Line 15 here.
$ _______________________________________
Make your payment payable to the “Illinois Department of Revenue”
and mail your completed form and payment to:
ILLINOIS DEPARTMENT OF REVENUE
RETAILERS’ OCCUPATION TAX
SPRINGFIELD IL 62776-0001
If you have questions,
call us at:
1 800 732-8866 or 217 782-3336; or call our
TDD-telecommunications device for the deaf at 1 800 544-5304.
visit us at:
tax.illinois.gov
This form is authorized by the Illinois Retailers’ Occupation and Related Tax Acts. Disclosure of this information is REQUIRED.
ST-4 front (R-3/09)
Failure to provide it could result in a penalty. This form has been approved by the Forms Management Center.
IL 492-3203
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