Form St-6 - Claim For Verified Overpayment
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1Illinois Department of Revenue
ST-6
Claim for Verified Overpayment
REV 01
FORM 056
E S _____/_____/_____
NS
DP
CA
RC
Do not write above this line.
Part 1: Identify your business
1
IBT no. _____________________________________________
“X” only if address is different from the address on your original
Illinois business tax number
return and complete Item 3 below.
2
3
Business name _______________________________________
Mailing address _______________________________________
Number and street
_____________________________________________________
City
State
ZIP
Part 2: Tell us why are you filing this claim
Check one of the following reasons.
1 _____ I have a balance of verified credit from a quarter-monthly or
2 _____ I have a balance of verified credit on file because I overpaid
prepaid sales tax payment that I want to have
a monthly return or an assessment. The return was for
liability period _________________________________; or,
a
_____ transferred to another Illinois business tax number.
the assessment identification (ID) number was
That number is ___________________________.
_______________________________________________.
b
_____ converted to a (check only one)
I want the credit (check only one)
a
_____ credit memorandum
_____ transferred to another Illinois business tax number.
_____ cash
That number is ___________________________.
b
_____ converted to a (check only one)
_____ credit memorandum
_____ cash
Part 3: Tell us the amount of the overpayment
What is the total amount of verified overpayment you are claiming?
$____________________________________________________
Part 4: Sign below
Under penalties of perjury, I state that I have examined this claim and, to the best of my knowledge, it is true, correct, and complete.
(
)
-
Owner, partner, or officer’s signature
Title and company affiliation
Phone
Date
(
)
-
Paid preparer’ signature
Phone
Date
Mail to:
SALES TAX PROCESSING DIVISION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19013
SPRINGFIELD IL 62794-9013
This form has been authorized by the Illinois Retailers’ Occupation Tax Act. Disclosure of this information is REQUIRED. Failure
to provide information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-2734
ST-6 front (R-4/97)
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