Form Rg-1 - Gas Revenue Tax Return - Illinois Department Of Revenue
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1Illinois Department of Revenue
RG-1
Gas Revenue Tax Return
Do not write above this line.
Step 1: Identify your business
1
6
Illinois business tax no. ___ ___ ___ ___ - ___ ___ ___ ___
Check the appropriate box and complete the
requested information. This return is for
G
2
Certificate of registration no. ___ - ___ ___ ___ ___
the month of__________________,19 ___.
the quarter ending_____________, 19 ___.
3
Taxpayer’s name____________________________________________________
the year 19 ___.
4
7
Business name_____________________________________________________
Is this an amended return? ____ yes ____ no
5
8
Business address___________________________________________________
Is this a final return?
____ yes
____ no
Number and street
A “final” return means that you sold or discontinued
your business and you no longer owe gas revenue
__________________________________________________________________
tax. If you answer “yes,” complete Section 1 on the
City
State
ZIP
back of this return.
Step 2: Figure your receipts subject to tax
9
9
Write your gross receipts (defined on back) from sales of gas taxed on a gross-receipts basis.
___________|___
10
Write your deductions (only tax-exempt receipts you included on Line 9).
a
10a
Receipts from interstate commerce
___________|___
b
10b
Receipts from rebillable service
___________|___
c
10c
Other (You must complete Section 2 on the back of this return.)
___________|___
11
11
Add Lines 10a through 10c. This amount is your total deduction.
___________|___
12
12
Subtract Line 11 from Line 9. This amount is your receipts subject to tax.
___________|___
Step 3: Figure your therms of gas subject to tax
13
13
Write your total therms of gas taxed on a per-therm basis.
___________|___
14
Write your deductions (only tax-exempt therms you included on Line 13).
a
14a
Therms of gas sold or distributed in interstate commerce
___________|___
b
14b
Therms of gas to be rebilled
___________|___
c
14c
Other (You must complete Section 3 on the back of this return.)
___________|___
15
15
Add Lines 14a through 14c. This amount is your total deduction.
___________|___
16
16
Subtract Line 15 from Line 13. This amount is your therms of gas subject to tax.
___________|___
Step 4: Figure your tax due
17
17
Multiply Line 12 by 5% (.05). This is the tax on your receipts.
___________|___
18
18
Multiply Line 16 by 2.4¢ (.024) per therm of gas. This is the tax on your therms of gas.
___________|___
19
19
Add Lines 17 and 18. This is the total gas revenue tax due.
___________|___
20
20
If you pay on a quarter-monthly basis, write the amount you paid in estimated payments. If not, write “0.”
___________|___
21
21
Write the total tax credit you wish to apply (excluding any credit memoranda).
___________|___
22
22
Add Lines 20 and 21. This is the tax you have already paid.
___________|___
23
If Line 22 is greater than or equal to Line 19, subtract Line 19 from Line 22. This is the amount you overpaid.
23
Go to Step 5.
___________|___
24
24
If Line 22 is less than Line 19, subtract Line 22 from Line 19. This is the balance due.
___________|___
25
25
Write the total credit you wish to apply from a credit memorandum. Attach the original credit memorandum.
___________|___
26
26
Subtract Line 25 from Line 24. Please pay this amount.
___________|___
Make your check payable to “Illinois Department of Revenue.”
Step 5: 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.
________________________________________________________________________(____)____________________________________
Taxpayer’s signature
Title
Telephone number
Date
________________________________________________________________________(____)____________________________________
Paid tax preparer’s signature
Name of firm or employer, if any
Telephone number
Date
Mail this return and any payment you owe to:
GAS REVENUE TAX
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19019
SPRINGFIELD IL 62794-9019
This form is authorized as outlined by the Gas Revenue Act. Disclosure of this information is REQUIRED. Failure to
provide information could result in a fine. This form has been approved by the Forms Management Center. IL-492-1401
RG-1 front (R-12/00)
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