Form Cmft-2 - Multiple-Site Form
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1Illinois Department of Revenue
CMFT-2
Multiple-Site Form (Attach to Form CMFT-1)
REV 01 FORM 025
Do not write above this line.
Account ID: ______________________________ This form is for: _______________________________________
Reportng Period (month day year - month day year)
You must round your fi gures to whole dollars. See instructions.
Site where the taxable retail sale was made:
Column A
Column B
Number of taxable gallons
Amount of tax
4
______________
X
=
5
______________
Location code
_____________________________________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
4
______________
X
=
5
______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
4
______________
X
=
5
______________
Location code
_____________________________________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
4
______________
X
=
5
______________
Location code
_____________________________________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
4
______________
X
=
5
______________
Location code
_____________________________________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Column totals (See instructions for multiple pages.)
______________
______________
Write the total of
Write the total of
Column A on Line 4
Column B on Line 5
This form is authorized by the County Motor Fuel Tax Law. Disclosure of this
information is REQUIRED. Failure to provide information could result in penalty.
of Form CMFT-1.
of Form CMFT-1.
This form has been approved by the Forms Management Center. IL-492-2250
CMFT-2 (R-12/09)
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Parent category: Financial