Form St-14 - Chicago Soft Drink Tax Return
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Illinois Department of Revenue
ST-14
Chicago Soft Drink Tax Return
Rev 3 Form 077
Account ID: ______________________ This form is for: __________________________________
E S ____/____/____
Reporting Period (month day year - month day year)
NS DP
CA RC
Owner’s name:
_________________________________________________________________________
Do not write above this line.
Business name: _________________________________________________________________________
Mailing address: _________________________________________________________________________
_________________________________________________________________________
You must round your figures to whole dollars. See instructions.
Step 1: Figure your taxable receipts
1
Total receipts - Write the total you received from sales of soft drinks, including soft drink tax you collected.
Do not include any other tax you collected.
1
__________________
2
Deductions
a
2a __________________
Write taxes included in Line 1.
b
Write tax-exempt sales included in Line 1.
2b __________________
Add Line 2a and Line 2b.
2
__________________
3
3
Taxable receipts (Subtract Line 2 from Line 1.)
__________________
Step 2: Figure your net tax and discount
4
4
Tax due on receipts. (Multiply Line 3 by 3% (.03).)
__________________
5
5
If you filed and paid by the due date, multiply Line 4 x 1.75% (0.0175).
__________________
6
Net tax due (Subtract Line 5 from Line 4.)
6
__________________
7
Excess Chicago Soft Drink tax collected
7
__________________
8
8
Total tax (Add Line 6 and Line 7.)
__________________
Step 3: Figure your payment due
9
Credit amount
9
__________________
10 Payment due (Subtract Line 9 from Line 8.)
Make your check payable to Chicago Soft Drink Tax.
10
__________________
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.
________________________________________________________________________________________________
Taxpayer’s signature
Phone
Date
________________________________________________________________________________________________
Preparer’s signature
Phone
Date
Mail your completed return and payment to: Chicago Soft Drink Tax Administration, PO Box 642603, Chicago, IL 60664-2603
This form is authorized by the ordinance of the city council of Chicago and related tax acts. imposing the tax for which this form is filed. Disclosure of this information is
REQUIRED. Failure to provide this information may result in this form not being processed and may result a penalty.
ST-14 (R-5/10)
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