Form St-1-X - Amended Sales And Use Tax And E911 Surcharge Return
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Illinois Department of Revenue
ST-1-X
Amended Sales and Use Tax and E911 Surcharge Return
REV 05 FORM 003 Station 820, 833
E S ____/___/____
NS
DP
CA
RC
General Information
Do not write above this line.
Everyone must complete Steps 1, 2, 4, and 5.
$
Amount you are paying:
You must also complete Step 3 if you believe that you
Make your check payable to "Illinois Department of Revenue."
have overpaid.
Step 1: Identify your business.
1 Account ID:
3
____ ____ ____ ____ - ____ ____ ____ ____
Business name: _________________________________
2
Reporting period you are amending:
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Month Day
Year
Month Day
Year
Step 2: Mark the reason why you are filing an amended return .
1
3
____ Overpaid (Complete Step 3)
____ Response to notice or bill
2
____ Underpaid
4____ Corrections to line items but no additional tax due
Step 3: Mark the reason(s) why you have overpaid your return.
If you collected the overpaid tax or E911 Surcharge from your customer(s), you must have uncon-
ditionally refunded the overpaid amount to your customer(s) before you file a claim for credit.
1 ___I am decreasing Line 1 or I am increasing Line 2 because
5 ___The tax base is correct but I put it on the wrong tax line.
I sold merchandise
6 ___I made a math error calculating Lines 9,11,15, 20, 23, or 25.
a ___to another Illinois business for resale. List the account
7 ___I failed to take the discount or made a math error calculating
the discount.
ID(s) on Schedule RE and attach to Form ST-1-X.
8 ___I made errors completing Form ST-2, Multiple Site Form.
b ___to an out-of-state customer and it was delivered to a
location outside Illinois.
9 ___I am a retailer who is exchanging Manufacturer's Purchase
c ___to an exempt organization. List the tax exempt (E)
Credit from a customer for cash previously paid.
number(s) on Schedule RE and attach to Form ST-1-X.
10 ___I overpaid use tax because I failed to use Manufacturer's
d ___that qualifies for a tax exemption for machinery or
Purchase Credit to pay use tax.
equipment used in manufacturing, farming, or graphic arts.
11 ___I overpaid use tax because the item
e ___that qualifies for an enterprise zone exemption.
a ___qualifies for a tax exemption for machinery or equipment
used in manufacturing, farming, or graphic arts.
f ___that was returned by my customer.
b ___qualifies for an enterprise zone exemption.
2 ___I included receipts from prior month(s) or used the wrong
month's receipts.
c ___was shipped to and used at a site outside Illinois.
3 ___I failed to include tax collected in Line 2.
d ___was returned to my supplier.
4 ___I used the wrong tax rate.
Turn page to complete Steps 4 and 5.
*300301110*
This form is authorized by the Retailers’ Occupation Tax Act and related Acts. Disclosure of this information is REQUIRED.
ST-1-X (R-2/13)
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center.
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