Form Ef-1 - Enrollment For Electronic Filing Program
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1Illinois Department of Revenue
EF-1
Enrollment for Electronic Filing Program
Read this information first
Form EF-1, must be completed by all excise taxpayers who are either required to or wish to volunteer to file their tax returns
electronically. Form EF-1 must also be completed by electronic return transmitters (if other than the actual excise taxpayer) and
software developers. Transmitters and software developers must complete this form and sign Step 6. Taxpayers or other individuals
responsible for filing returns who are not transmitters or software developers must complete this form and sign Step 5. Signature
stamps will not be accepted. Note: Currently, only the excise tax types listed in Step 4 have the option to electronically file returns.
Step 1: Identify the business that is completing this enrollment form
1
4
Name:_______________________________________________
Illinois Business Tax number (IBT no.): __ __ __ __- __ __ __ __
2
5
Mailing address:_______________________________________
Fed. Employer Identification no. (FEIN): _____-_______________
_______________________________________________
6
FAX number: (____)_____ - _______________
City
State
ZIP
3
Email address: _______________________________________
Step 2: Tell us the reason you are completing Form EF-1- check all that apply
I am required to file my return electronically
I am revising a previously filed Form EF-1
I chose to volunteer to file my returns electronically
I am a software developer - Sign in Step 6
I am a transmitter that will transmit electronic returns directly to the Illinois Department of Revenue (IDOR) - Sign in Step 6.
Step 3:
Identify your contact person -
Contact may be necessary during testing and throughout the electronic filing process
7
Primary contact: _______________________________________
Daytime telephone: (____)_____ - _______________
Email address:_________________________________________
FAX number: (____)_____ - _______________
8
Alternate contact: ______________________________________
Daytime telephone: (____)_____ - _______________
Email address:_________________________________________
FAX number: (____)_____ - _______________
Step 4: Check all tax types that apply to this enrollment
Liquor Revenue Tax
Liquor Airline Revenue Tax
Cigarette Tax
Cigarette Use Tax
Telecommunications Tax
Gas Tax
Step 5: Taxpayers or other individuals responsible for filing returns only - Provide your electronic signature
You must select a six character code to represent your signature when you electronically file your return: ___ ___ ___ ___ ___ ___
Note:
Your code may be alpha and/or numeric. Note: If you wish to change your signature code, you must complete a “revised” Form EF-1.
Under penalties of perjury, I state that I have examined this form and to the best of my knowledge, it is true, correct, and complete. I
authorize IDOR to provide my transmitter with information regarding the transmission of my electronic return. In addition, I agree
that this signature shall be deemed to appear on any electronic returns submitted that include my electronic signature. All returns filed
electronically as authorized by this enrollment form are deemed to be accurate, complete, and truthful statements made under penalties of
perjury. This enrollment form and electronic signature shall remain in force until IDOR receives written notification from the taxpayer. IDOR
reserves the right to suspend or revoke the electronic filing participant from the program after proper notice is given.
_____________________________________________________
Title: ________________________________________________
Printed name
___________________________________ ____/____/________
Social Security number: ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Signature
Date
Step 6: Software developers and transmitters only - Sign here
Under penalties of perjury, I state that I have examined this form and to the best of my knowledge, the information is true, correct, and
complete. I state that this firm, including employees, will comply with all provisions of the Illinois Electronic Filing Program. I understand that
acceptance for participation is not transferrable and that noncompliance will void participation in the program. I am authorized to make and
sign statements on behalf of the firm. IDOR reserves the right to suspend or revoke the electronic filing participant from the program after
proper notice is given.
_____________________________________________________
Social Security number: ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Printed name
___________________________________ ____/____/________
Daytime telephone: (____)_____ - _______________
Signature
Date
Step 7: Mail Form EF-1
Mail Form EF-1 to
MISCELLANEOUS TAXES DIVISION
ILLINOIS DEPARTMENT OF REVENUE
This form is authorized as outlined by the Illinois Administrative Code, Title 86, Part 760.
PO BOX 19039
Disclosure of this information is required of those taxpayers to whom this form applies.
This form has been approved by the Forms Management Center. IL-492-4296
SPRINGFIELD IL 62794-9039
EF-1 (R-07/03)
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