Form Rt-10 - Telecommunications Infrastructure Maintenance Fee (Timf) Return
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Illinois Department of Revenue
RT-10
Telecommunications Infrastructure
REV 3
Form 895
E S ___/___/___
Maintenance Fee (TIMF) Return
NS
DP
CA
Station no. 060
Do not write above this line.
Identify your business
Account ID: ____ ____ ____ ____ ____ ____ ____ ____
Complete the information to indicate the tax period
for which you are filing this return:
License no.: ___ - ___ ___ ___ ___ ___
Month of __ __/__ __ __ __
Quarter ending __ __/__ __ __ __
Taxpayer’s name: ____________________________________________________
Year __ __ __ __
Business’ name: _____________________________________________________
Check here if your address has changed.
Business’ address: ___________________________________________________
Is this a final (you are no longer in business)
Number and street
return?
yes
no
____________________________________________________________________
City
State
ZIP
Step 1: Figure your TIMF due
Net gross charges:
1
1
Gross charges (see instructions) billed during this liability period.
_______________________
2
2
Amount you received during this liability period on credit previously extended.
_______________________
3
3
Add Lines 1 and 2. This amount is your total gross charges.
_______________________
4
Deductions:
a
4a
Gross charges billed to the federal government
_______________________
b
4b
Gross charges billed for wireless telecommunications
_______________________
c
4c
Fee-free sales billed to resellers
_______________________
d
4d
Other. Explain: _____________________________________
_______________________
5
5
Add Lines 4a through 4d. This amount is your total deduction.
_______________________
6
Subtract Line 5 from Line 3. This amount is your net gross
6
charges subject to the State TIMF.
_______________________
7
7
Multiply Line 6 by 0.5% (.005). This is your State TIMF due.
_______________________
8
8
If you file this return and pay the amount due by the due date, multiply Line 7 by 2% (.02).
_______________________
9
9
Subtract Line 8 from Line 7.
_______________________
10
10
Credit you wish to apply.
_______________________
11
11
Subtract Line 10 from Line 9. Pay this amount.
_______________________
Make your check payable to “Illinois Department of Revenue”
Step 2: 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.
_____________________________
________________________ (____)____-___________ ____/____/________
Title:
Owner or officer’s signature and title (state if individual owner, member of firm, or corporate officer title)
Telephone number (include area code)
Date
_____________________________
________________________ (____)____-___________ ____/____/________
Title:
Preparer’s signature and title (state if individual owner, member of firm, or corporate officer title)
Telephone number (include area code)
Date
Note: You can file Form RT-10 electronically using MyTax Illinois at tax.illinois.gov.
*289501110*
RT-10 (R-11/12)
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is
required. Failure to provide information may result in this form not being processed and may result in a penalty.
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