Utility Tax Return Form - City Of Peoria

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CITY OF PEORIA, ILLINOIS
UTILITY TAX RETURN
Business
Taxpayer
Name:
_____________________________________
Number: _______________________________
( * City assigned – not state tax or FEIN # )
Mailing
Address: _____________________________________
This return filed for the period:
_____________________________________
From:_____________________ To:______________________
Phone:
_____________________________________
Fax:
_____________________________________
Under penalty as provided by law, I declare that I have examined
this return and accompanying schedules and to the best of my
E-Mail:
_____________________________________
knowledge and belief it is true and correct and is taken from the
books and records of the business for which this is filed. All
Corporate
returns must be filed on or before the last day of the calendar
Name:
____________________________________
month succeeding the end of the filing period.
______________________________________________
__________________________________________________
Taxpayer signature and title
Preparer’s signature and phone number
______________________________________________
__________________________________________________
Print taxpayer name
Print preparer’s name
TOTAL GROSS RECEIPTS**:
1.
___________________________________
UTILITY TAX:
2.
___________________________________
(line 1 multiplied by 5.0%)
LATE PENALTY:
3.
___________________________________
(line 2 x 5.0%)
LATE INTEREST:
4.
___________________________________
(line 2 x 2% x # of months delinquent)
TOTAL UTILITY TAX & CHARGES DUE:
5.
___________________________________
(line 2 + 3 + 4)
* This number is assigned to your business by the City of Peoria, Illinois and is required by our software. Do not use your state sales tax number or your FEIN
number, call (309) 494-8588 if you are unsure of the correct number to use.
**Gross receipts are exclusive of tax. Gross receipts are defined as the consideration received for the transmission of messages, or for distributing, supplying, or
furnishing or selling electricity for use or consumption and not for resale, as the case may be; and for all services rendered in connection therewith; and shall be
determined without any deduction on account of cost of the service, product or commodity supplied, the cost of material used, labor or service cost, or any other
service whatsoever.
Make checks payable to:
City of Peoria
Mail to:
City Treasurer’s Office
419 Fulton Street, Room 100
Peoria, IL 61602
Questions or additional forms:
Accounts Receivable Office
419 Fulton Street, Room 111
Peoria, IL 61602
(309) 494-8588
5/01

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