Form St-1 - Sales And Use Tax And E911 Surcharge Return, St-2 - Multiple Site Form - 2016 Page 2

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Account ID: _________________________ This form is for: ____________________________________
Schedule A — Deductions
Section 1: Taxes and miscellaneous deductions - If no Section 1 deductions, go to Section 2.
1
1
Taxes collected on general merchandise sales and service
______________|_____
2
2
f
Taxes collected on
ood, drugs, and medical appliances sales and service
______________|_____
3
3
E911 Surcharge and ITAC Assessment collected
______________|_____
4
4
Resale
______________|_____
5
5
Interstate commerce
______________|_____
6
6
Manufacturing machinery and equipment (including photoprocessing)
______________|_____
7
7
Farm machinery and equipment
______________|_____
8
8
Graphic arts machinery and equipment (Expired August 30, 2014)
______________|_____
9
9
Supplemental Nutrition Assistance Program (SNAP - formerly called food stamps)
______________|_____
10
Enterprise zone
a
10a
Sales of building materials
______________|_____
b
10b
Sales of items other than building materials
______________|_____
11
High impact business
a
11a
Sales of building materials
______________|_____
b
11b
Sales of items other than building materials
______________|_____
12
12
River edge redevelopment zone building materials
______________|_____
13
13
Exempt organizations
______________|_____
14
14
Tax paid on uncollectible debt
______________|_____
15
15
Sales of service - identify here ____________________
______________|_____
16
Other (including cash refunds, newspapers and magazines, etc.) - identify below
16
_________________________________________________
______________|_____
17
17
Total Section 1 deductions. Add Lines 1 through 16.
______________|_____
Section 2: Motor fuel deductions - If no Section 2 deductions, go to Section 3.
State motor fuel tax
Number of gallons
Rate
18
18a
18b
Gasoline
______________
x
19¢
=
______________|_____
19
19a
19b
Gasohol and majority blended ethanol
______________
x
19¢
=
______________|_____
20
20a
20b
Diesel (including biodiesel and biodiesel blends)
______________
x
21.5¢
=
______________|_____
21
21a
21b
Dieselhol
______________
x
21.5¢
=
______________|_____
22
22a
22b
Other special fuels
______________
x
19¢
=
______________|_____
Specific fuels sales tax exemption
Receipts
Percentage
23
23a
23b
Gasohol
______________|_____ x 20% (.20) =
______________|_____
24
24a
24b
Biodiesel blend
______________|_____ x 20% (.20) =
______________|_____
(90 - 99 percent petroleum-based product)
25
25a
25b
)
Biodiesel blend
______________|_____ x 100% (1.00) =
______________|_____
(1- 89 percent petroleum-based product
26
26a
26b
100 percent biodiesel
______________|_____ x 100% (1.00) =
______________|_____
27
27a
27b
Majority blended ethanol fuel
______________|_____ x 100% (1.00) =
______________|_____
28
28
Other motor fuel deductions________________________________
______________|_____
29
29
Total Section 2 deductions. Add Lines 18b through 28.
______________|_____
Section 3: Total deductions
30
30
Add Lines 17 and 29. Enter this amount on Step 2, Line 2 on the front page of this return.
______________|_____
Schedule B — E911 Surcharge and ITAC Assessment
Receipts from retail transactions of prepaid wireless telecommunications service
1
1
Enter receipts subject to E911 Surcharge and ITAC Assessment.
______________|_____
Figure your breakdown of retail transactions for Chicago locations
2
2a
2b
For Chicago locations
______________|_____ x _____
=
______________|_____
3
3a
3b
For Chicago locations at prior rates
______________|_____ x _____
=
______________|_____
4
4
Total for Chicago. Add Lines 2b and 3b.
______________|_____
Figure your breakdown of retail transactions for non-Chicago locations
5
5a
5b
For non-Chicago locations
______________|_____ x _____
=
______________|_____
6
6a
6b
For non-Chicago locations at prior rates
______________|_____ x _____
=
______________|_____
7
7
Total for non-Chicago locations. Add Lines 5b and 6b.
______________|_____
Figure your net E911 Surcharge and ITAC Assessment
8
8
Total E911 Surcharge and ITAC Assessment. Add Lines 4 and 7.
______________|_____
9
9
If you filed and paid by the due date, multiply Line 8 by 3% (.03).
______________|_____
10
10
Subtract Line 9 from Line 8. Enter this amount on Step 7, Line 21.
______________|_____
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is
IDOR ST-1
required. Failure to provide information may result in this form not being processed and may result in a penalty.
ST-1 back (R-06/16)
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