Form St-14-X - Amended Chicago Soft Drink Tax Return Page 2

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Step 3: Correct your financial information
Column A
Column B
Please round to the nearest whole dollar.
Most recent figures filed
Figures as they should
have been filed
1 Write your total Chicago soft drink receipts.
1 ________________________
1 ________________________
2 Deductions
a Write taxes included in Line 1.
2a ________________________ 2a ________________________
b Write tax-exempt sales included in Line 1.
2b ________________________ 2b ________________________
Add Line 2a and Line 2b.
2 ________________________
2 ________________________
3 Subtract Line 2 from Line 1. This amount is your taxable receipts. 3 ________________________
3 ________________________
4 Multiply Line 3 by 3 percent (.03). This is your tax due on receipts. 4 ________________________
4 ________________________
5 Write the amount of your discount. (See instructions.)
5 ________________________
5 ________________________
6 Subtract Line 5 from Line 4. This is your net tax due.
6 ________________________
6 ________________________
7 Write the excess tax collected.
7 ________________________
7 ________________________
8 Add Lines 6 and 7. This is your tax due.
8 ________________________
8 ________________________
9 Write the credit amount.
9 ________________________
9 ________________________
10 Subtract Line 9 from Line 8. This is your net tax due.
10 ________________________ 10 ________________________
11 Write the total amount you have paid.
11 ________________________
12 If Line 11 is greater than Line 10, Column B, write the difference.
This is the amount you have overpaid. Go to Step 4.
12 ________________________
13 If Line 11 is less than Line 10, Column B, write the difference.
This is the amount you have underpaid. Please pay this amount.
We will bill you for any penalty and interest that is due. Go to Step 4.
13 ________________________
Make your check payable to “Chicago Soft Drink Tax.”
Please write the amount you are paying on the line provided on the front of this return.
Step 4: Sign below
Under penalties of perjury, I state that I have examined this return, and to the best of my knowledge, it is true, correct, and
complete. Under penalties of perjury, I state that I have unconditionally refunded to my customer(s) any overpaid sales tax that I
collected from my customer(s) and am claiming as an overpayment on this return.
(
)
-
Owner, partner, or officer’s signature
Title
Phone
Date
(
)
-
Paid preparer’s signature
Phone
Date
Mail to:
CHICAGO SOFT DRINK TAX ADMINISTRATION
PO BOX 19034
SPRINGFIELD IL 62794-9034
*110332110*
ST-14-X back (R-4/11)
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