Schedule I - Income Received - Illinois Department Of Revenue
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*063901110*
Illinois Department of Revenue
Year ending
Schedule I
____ ____
Month
Year
Income Received
Attach to your Form IL-1041.
IL Attachment No. 8
Write your name as shown on your Form IL-1041.
Write your
federal employer identifi cation number (FEIN).
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Identify the entities from whom you received income
A
B
C
Type
Name and address
FEIN
(see instructions)
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Schedule I Front (IL-1041) (R-12/10)
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