Form Il-1000-E - Certificate Of Exemption For Pass-Through Entity Payments
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1Illinois Department of Revenue
Certificate of Exemption for Pass-through
Form IL-1000-E
Entity Payments
Read this information first
In the event that we notify you that the certificate has been revoked,
Owners:
the certificate remains valid for 60 days after the date of notification,
Form IL-1000-E, Certificate of Exemption for Pass-through Entity
and you must then begin withholding for business income
Payments, should be completed by any owner (partner,
distributable to the owner.
shareholder, or beneficiary) that elects to make their own tax
If the certificate has been revoked, you may not accept another
payments on business income from a pass-through entity
(partnership, shareholder, or fiduciary). Individuals may not make
certificate from the owner until we notify you.
the exemption election.
Specific information for both owners and pass-through
Pass-through entities:
entities:
In order to accept Form IL-1000-E, make sure that the certificate is
Form IL-1000-E must only be completed, signed, and submitted
completed and signed by the owner, officer, fiduciary, or authorized
once to the pass-through entity. It does not need to be resubmitted
representative. Keep the certificates in your files. Do not send them
on an annual basis. Do not send Form IL-1000-E to us unless we
to us unless we specifically request them from you.
specifically request it from you.
Step 1: Identify the pass-through entity
The pass-through entity must keep this certificate.
(
)
Name
Phone number
Federal employer identification number (FEIN)
Mailing address
City
State
ZIP
Step 2: Identify the owner (partner, shareholder, or beneficiary)
Federal employer identification number (FEIN)
Name
Mailing address
Check the box to indicate your business type:
City
State
ZIP
Corporation
Subchapter S corporation
(
)
Partnership
Phone number
Trust
Estate
Step 3: Sign below
I certify that the owner indicated in Step 2 will file all Illinois income tax returns and make timely payment of all Illinois income
taxes due, and that it is subject to personal jurisdiction of the State of Illinois for purposes of the collection of income taxes due
with respect to income from the partnership, corporation or trust indicated in Step 1 of this certificate.
Signature of owner, officer, fiduciary, or authorized representative
Date
Printed Name
Title
This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this
information is REQUIRED. Failure to provide information could result in a penalty.
IL-1000-E (R-12/12)
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