Form Rc-55 - Unstamped Little Cigar Sticks Tax Return
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1Illinois Department of Revenue
REV 01 FORM 94A
E S
_ _/_ _/_ _ _ _
Unstamped Little Cigar Sticks Tax Return
RC-55
NS
DP
CA
RC
(Not in packages of 20 or 25)
Station no. 592 (Out-of-state: Station no. 599)
Do not write above this line.
Step 1:
Identify your business
1
5
Account ID: ____ ____ ____ ____ ____ ____ ____ ____
For what tax period are you filing this return?
___ ___/___ ___ ___ ___
Month
Year
2
License no.: ___ ___ - ___ ___ ___ ___ ___
6
Check if your address has changed.
3
Business name: ______________________________________________________
7
Is this a final (you are no longer in
4
Business address: ____________________________________________________
business) return?
yes
no
Number and street
___________________________________________________________________
Check here if your license number begins
City
State
ZIP
with a “U”.
Step 2
: Figure your tax due
8
Enter the total number of little cigar sticks sold in unstamped packages containing any
8
quantity other than 20 or 25 sticks for the reporting period.
___________________
9
9
Multiply Line 8 by 99 mills ($0.099).
$__________________
10
10
Discount
$__________________
11
11
Subtract Line 10 from Line 9. This is the tax due.
$__________________
12
12
Excess tax collected
$__________________
13
13
Add Line 11 and Line 12. This is the total tax due.
$__________________
14
14
Credit you wish to apply.
$__________________
15
15
Subtract Line 14 from Line 13. This is your net tax due.
$__________________
Pay this amount and make your check payable to “Illinois Department of Revenue.”
Step 3:
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: ________________________
(____) ____-____________________
____/____/________
Taxpayer's signature
Telephone number (include area code)
Date
_____________________________ Title: ________________________
(____) ____-____________________
____/____/________
Preparer’s signature
Telephone number (include area code)
Date
Step 4:
Mail your completed return with payment to:
ALCOHOL TOBACCO AND FUEL DIVISION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19019
SPRINGFIELD IL 62794-9019
*394A11110*
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.
RC-55 (R-07/13)
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