Estimated Gross Revenue Return Form - Illinois Commerce Commission - 2013
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CHECK ONE
ILLINOIS COMMERCE COMMISSION
JANUARY
0
APRIL
ESTIMATED GROSS REVENUE RETURN
1
JULY
For Public Utilities and Rail Carriers
OCTOBER
3
Period: 01/01/2013 through 12/31/2013
Tax Contact (Officer or other person to receive questions regarding tax return)
CHECK HERE IF THIS IS AN AMENDED RETURN
DATE AMENDED
__________________
TAX PREPARER REQUIRED INFORMATION
Tel:
Fax:
Email:
CHECK HERE IF THIS IS AN ADDRESS CHANGE
SEE INSTRUCTIONS ON REVERSE SIDE
FEIN #
1.
a
ESTIMATED Gross Operating Revenue for the calendar year ending December 31, 2013
1a
(See instructions Line 1a for your basis of reporting revenues.)
b
Estimated revenue from Illinois-related Interstate or International service and/or estimated revenue from
other non-Illinois state jurisdictions
1b
c
Total Illinois Intrastate Gross Revenue (Line 1a minus Line 1b)
1c
2.
Estimated Illinois Intrastate Deductions: (THIS SECTION IS FOR USE BY PUBLIC UTILITIES ONLY)
a
Revenue from sale to utilities or electric cooperatives for resale
2a
b
Uncollectable accts (only if filing on ACCRUAL basis – see instructions 1a) 2b
c
Other deductions (must itemize on separate sheet, see instructions)
2c
d
Total Estimated Illinois Intrastate Deductions
2d
3.
Estimated Illinois Gross Revenue subject to tax (Line 1c minus Line 2d)
3
4.
Estimated tax payable for the calendar year ending December 31, 2013 (Public Utilities – Line 3 x .001)
(Rail Carriers – Line 3 x .0015)
4
5.
Deduct Previous Payments and Credit Memos:
a
Credit Memorandum No.
____________ (Original must be attached) 5a
b
Total prior credit memos submitted with previously filed 2013 returns, if any 5b
c
Total payments made with previously filed 2013 returns, if any
5c
d
Total of credit memos and payments submitted with previously filed 2013 returns, if any
5d
6.
Unpaid/(Overpaid) Estimated Tax balance (Line 4 minus Line 5d)
6
7.
Tax Payment to be remitted with return (No payment necessary if amount due is 99 cents or less)
7
8.
Account balance (Line 6 minus Line 7)
8
OATH: 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.
Officer’s Signature
Please type or print Officer’s Name and Title
IMPORTANT
The term Public Utility and Utility as used on this form includes Telecommunications Carriers as defined under the Public Utilities Act (220 ILCS 5/13-101).
To avoid penalties, the original of this RETURN with REMITTANCE, must be filed with the FISCAL INFORMATION SECTION of the ILLINOIS COMMERCE COMMISSION, 527 East Capitol
Avenue, Springfield, IL 62701 on or before the 10
day of (JANUARY, APRIL, JULY OR OCTOBER) of the applicable tax year.
th
Make check, draft or money order payable to: (Public Utilities) ILLINOIS COMMERCE COMMISSION – Public Utility Fund
(Railroads) ILLINOIS COMMERCE COMMISSION – Transportation Regulatory Fund
Disclosure of information is MANDATORY and the purpose is outlined under the Public Utilities Act (220 ILCS 5/2-202) and the Illinois Commercial Transportation Law [625 ILCS 5/18c-1502].
Failure to provide any information could result in substantial penalties.
AGENCY USE ONLY
Posted by: ______________________
Date: ______________________
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