Schedule Cf-1 (Form Rc-12-A) - Value Of Stamps Purchased And Stamp Credit Memoranda

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Illinois Department of Revenue
REV 01 FORM 444
RC-12-A
Schedule CF-1
Value of Stamps Purchased and Stamp Credit Memoranda
Read this information first
Sheet no. __________
After you have completed this schedule, make a copy for your records.
Attach the completed original schedule to either Forms RC-6, Cigarette and Little Cigar Revenue Return, RC-6-A, Out-of-
State Cigarette and Little Cigar Revenue Return, RC-6-X, Amended Cigarette and Little Cigar Revenue Return, or RC-6-A-X,
Amended Out-of-State Cigarette and Little Cigar Revenue Return.
For additional instructions, see Form RC-6, Form RC-6-A, Form RC-6-X, or Form RC-6-A-X.
Step 1:
Identify your business
Name: _ ____________________________________________ Account ID: __ __ __ __ __ __ __ __
Address: ___________________________________________ License no.: ___ - ___ ___ ___ ___ ___
Number and street
__________________________________________________ Tax period: __ __ / __ __ __ __
City
State
ZIP
Month
Year
Step 2:
List the value of your stamp purchases from Form RC-1-A, Step 3, Line 3
Date
Invoice
Amount
Date
Invoice
Amount
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
Total value of all stamps purchased:
$ ____________________.____
Step 3:
List the value of your credit memoranda used on stamp purchases
Date
Credit Memo #
Amount
Date
Credit Memo #
Amount
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
___________
___________
_ _/_ _/_ _ _ _
$____________________.____
_ _/_ _/_ _ _ _
$____________________.____
Total amount from credit memoranda(s) used on stamp purchases:
$ ____________________.____
*344411110*
RC-12-A (R-07/13) Schedule CF-1
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 required. Failure to provide information may result in this form not being processed and may result in a penalty.

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