Form St-2-Ts-X - Amended Expanded Temporary Storage Multiple Site Form
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Illinois Department of Revenue
ST-2-TS-X
Amended Expanded Temporary Storage Multiple Site Form
Attach to Form ST-1-X.
Rev 01 Form 099
Do not write above this line.
Business name: ___________________________________
Account ID:
____ ____ ____ ____ - ____ ____ ____ ____
Reporting period you are amending:
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Part 1 — List all locations within a county or a municipality with no business district sales tax.
You must round your fi gures to whole dollar amounts. See instructions.
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X ______
= 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Site name
_____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site address
_____________________________________
Food, drugs, and medical appliances
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
*909911110*
This form is authorized as outlined by the Use Tax Act and the Service Use 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-492-4580
ST-2-TS-X front (N-5/09)
Page ____ of ____
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