Schedule I - Attach To Your Form Il-1041 - Income Received

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Illinois Department of Revenue
Year ending
Schedule I
Month
Year
Income Received
Attach to your Form IL-1041.
IL Attachment No. 8
Write your
Write your name as shown on your Form IL-1041.
federal employer identification number (FEIN).
Identify the entities from whom you received income
A
B
C
Type
Name and address
FEIN
(see instructions)
1
2
3
4
5
6
7
Schedule I Front (IL-1041) (R-12/12)

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