Form Rg-6-X - Amended Assistance Charges Return For Natural Gas Distributors - 2002
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1
2Illinois Department of Revenue
RG-6-X
Amended Assistance Charges Return
REV 1
for Natural Gas Distributors
E S ___/___/___
Station 257
NS
DP
CA
Do not write above this line.
Step 1: Identify your business
1
Illinois Business Tax number (IBT no.): __ __ __ __ - __ __ __ __
7
Check here if your address has changed.
2
FEIN
___ ___ - ___ ___ ___ ___ ___ ___ ___
Federal employer identification number
8
Is this a final return?
yes
no
"Final” indicates you will no longer conduct business. If "yes,"
3
G A
License no. ___ ___ - ___ ___ ___ ___
complete the following: My business was
4
Name ______________________________________________
discontinued on: __ __/__ __/__ __ __ __.
sold on: __ __/__ __/__ __ __ __.
5
Address ____________________________________________
Number and street
If "sold," provide the new owner's name and address:
___________________________________________________
Name: _____________________________________________
City
State
ZIP
Address: ___________________________________________
6
Liability period ___ ___/___ ___ ___ ___
Month
Year
___________________________________________________
Step 2: Figure your assistance charges due - Figures as they should have been filed
Total number
Energy
Renewable
of accounts
Assistance Charge
Energy Charge
9
Total number of accounts to which you delivered residential gas
service and from which you collected the assistance charges
9
during this liability period.
_____________
10
10
Multiply Line 9 by $0.40.
__________|___
11
11
Multiply Line 9 by $0.05.
__________|___
12
Write the total number of accounts
• to which you delivered nonresidential gas service,
• to which you delivered less than 4 million therms of gas during
the previous calendar year, and
12
• from which you collected the assistance charges.
_____________
13
13
Multiply Line 12 by $4.00.
__________|___
14
14
Multiply Line 12 by $0.50.
__________|___
15
Write the total number of accounts
• to which you delivered nonresidential gas service,
• to which you delivered 4 million or more therms of gas during the
previous calendar year, and
15
• from which you collected the assistance charges.
_____________
16
16
Multiply Line 15 by $300.00
__________|___
17
17
Multiply Line 15 by $37.50
__________|___
18
18
Add Lines 10, 13, and 16. This amount is your total Energy Assistance Charge due.
__________|___
19
19
Add Lines 11, 14, and 17. This amount is your total Renewable Energy Charge due.
__________|___
20
20
Add Lines 18 and 19. This is your net tax due.
__________|___
21
21
Total amount you paid for this reporting period.
__________|___
22
22
If Line 21 is greater than Line 20, subtract Line 20 from Line 21.This is the amount you have overpaid.
__________|___
23
If Line 21 is less than Line 20, subtract Line 21 from Line 20.This is the amount you have underpaid.
23
Pay this amount and make your check payable to “Illinois Department of Revenue.”
__________|___
Step 3:
Check the reason you are filing this amended return
I made a computation error that resulted in an overpayment of tax.
• If you checked this box, did you collect the overpaid tax from your customer?
yes
no
• If you checked “yes,” did you unconditionally refund the overpaid tax?
yes
no
I made a computation error that resulted in underpayment of tax.
I should have taken a deduction for________________________________________________________________________________.
The original IBT no. was incorrect. The incorrect IBT no. is __ __ __ __-__ __ __ __.
The original reporting period was incorrect. The incorrect reporting period is ___________________________.
Other. Please explain ____________________________________________________________________________________________
_________________________________________________________________________________________________________________
Step 4: 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.
_____________________________
________________
(____)____-___________
____/____/________
Title:
Taxpayer’s signature and title (state if individual owner, member of firm, or corporate officer title)
Telephone number (include area code)
Date
_____________________________
________________
(____)____-___________
____/____/________
Firm:
Preparer's signature and name of the firm or employer (if applicable)
Telephone number (include area code)
Date
RG-6-X (N-06/02)
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