Form St-2-Ts-X - Amended Expanded Temporary Storage Multiple Site Form Page 2
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1
2ST-2-TS-X
Attach to Form ST-1-X.
Rev 01 Form 099
Business name:________________________________________
Account ID: ____ ____ ____ ____ - ____ ____ ____ ____
Reporting period you are amending:
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Month
Day
Year
Month
Day
Year
Part 2 — List all sites located in a municipality with a business district sales tax.
You must round your fi gures to whole dollar amounts. See instructions.
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X ______
= 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
General merchandise
Location code
_____________________________________
Business district _____________________________________
4a ________________ X _______ = 4b ________________
(rate)
Site name
_____________________________________
Food, drugs, and medical appliances
Site address
_____________________________________
5a ________________ X _______ = 5b ________________
(rate)
IL
City and ZIP
_____________________________________
Purchases at other rates
8a ________________
8b ________________
*909912110*
Page ____ of ____
ST-2-TS-X back (N-5/09)
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