Form Rl-48 - Application For Certificate Of Registration To Warehouse Alcoholic Liquors For Compensation - Illinois Department Of Revenue

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Illinois Department of Revenue
Application for Certificate of Registration to
RL-48
Warehouse Alcoholic Liquors for Compensation
Read this information first
File this application if you will be warehousing alcoholic liquors for
Mail your completed application to:
compensation.
MISCELLANEOUS TAXES DIVISION
ILLINOIS DEPARTMENT OF REVENUE
Once we have received and reviewed your application, we will issue
PO BOX 19019
you a certificate of registration to permit you to warehouse alcoholic
SPRINGFIELD IL 62794-9019
liquors for compensation.
If you have questions, call us at 217 782-6602.
Step 1: Identify your business
Business name __________________________________________
FEIN or SSN ____________________________________________
federal employer identification number or Social Security number
Corporate name _________________________________________
Illinois business tax (IBT) number __ __ __ __ - __ __ __ __
(if different than above)
In care of name __________________________________________
Daytime telephone number (______)___________________
Business address ________________________________________
Type of business ownership:
individual (sole proprietor)
Number and street
partnership
_______________________________________________________
corporation
City
State
ZIP
_______________________________________________________
County
Step 2: Tell us the addresses where you will store alcoholic liquor
Number and street
City
County
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
________________________________________
____________________________________
_______________________________
Step 3: Sign below
Under penalties of perjury, I state that I have examined this application and, to the best of my knowledge, it is true, correct, and complete.
______________________________________________________
_________________________________________
____________
Signature of owner, partner, or officer
Title
Date
______________________________________________________
_________________________________________
____________
If partnership, all partners must sign
Title
Date
Do not write below this line.
Date received
___________________________
Certificate number
__________________
Examined by
___________________________
Date issued
__________________
Approved by
___________________________
This form is authorized by the Liquor Control Act of 1934. Disclosure of this information is REQUIRED. Failure to provide
RL-48 (R-5/99)
information could result in denial of this application. This form has been approved by the Forms Management Center.
IL-492-2706

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