Form Il-501 - Payment Coupon - 2013
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1Illinois Department of Revenue
Check the appropriate box to tell us when you withheld the withholding income
Payment Coupon
tax you are paying. Check one box only.
IL-501
1
2
3
4
2013
Complete the following information.
Tax year
Jan
Apr
Jul
Oct
Feb
May
Aug
Nov
Mar
Jun
Sep
Dec
___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Federal employer identification number
Seq. number
$
_______________________________________________
Amount paid:
___________________.____
Business name
_______________________________________________
• Make check payable to “Illinois Department of Revenue” and write your
Number and street address
FEIN and “IL-501” on the check.
• Mail to:
ILLINOIS DEPARTMENT OF REVENUE
_______________________________________________
PO BOX 19447
City
State
ZIP
SPRINGFIELD IL 62794-9447
(_______)_______________________________________
Note:
Do not mail Form IL-501 if you electronically pay or are reporting a zero amount.
Daytime phone
IL501
IL-501 (R-12/12)
Illinois Department of Revenue
Check the appropriate box to tell us when you withheld the withholding income
Payment Coupon
tax you are paying. Check one box only.
IL-501
1
2
3
4
2013
Complete the following information.
Tax year
Jan
Apr
Jul
Oct
Feb
May
Aug
Nov
___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Mar
Jun
Sep
Dec
Federal employer identification number
Seq. number
_______________________________________________
$
Amount paid:
___________________.____
Business name
_______________________________________________
• Make check payable to “Illinois Department of Revenue” and write your
Number and street address
FEIN and “IL-501” on the check.
ILLINOIS DEPARTMENT OF REVENUE
• Mail to:
_______________________________________________
PO BOX 19447
City
State
ZIP
SPRINGFIELD IL 62794-9447
(_______)_______________________________________
Note:
Do not mail Form IL-501 if you electronically pay or are reporting a zero amount.
Daytime phone
IL501
IL-501 (R-12/12)
Illinois Department of Revenue
Check the appropriate box to tell us when you withheld the withholding income
Payment Coupon
tax you are paying. Check one box only.
IL-501
1
2
3
4
2013
Complete the following information.
Tax year
Jan
Apr
Jul
Oct
Feb
May
Aug
Nov
___ ___ - ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Mar
Jun
Sep
Dec
Federal employer identification number
Seq. number
_______________________________________________
$
Amount paid:
___________________.____
Business name
_______________________________________________
• Make check payable to “Illinois Department of Revenue” and write your
Number and street address
FEIN and “IL-501” on the check.
ILLINOIS DEPARTMENT OF REVENUE
• Mail to:
_______________________________________________
PO BOX 19447
City
State
ZIP
SPRINGFIELD IL 62794-9447
(_______)_______________________________________
Note:
Do not mail Form IL-501 if you electronically pay or are reporting a zero amount.
Daytime phone
IL501
IL-501 (R-12/12)
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Parent category: Financial