Form Cmft-1 - County Motor Fuel Tax Return
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1Illinois Department of Revenue
CMFT-1
County Motor Fuel Tax Return
Rev 02 Form 024
E S ____/____/____
Account ID: ______________________ This form is for: __________________________________
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: _________________________________________________________________________
_________________________________________________________________________
Step 1: Figure your taxable gallons
1
Total gallons sold -
Write the number of gallons of motor fuel you sold at retail within
1
___________________
DuPage, Kane, or McHenry County. (Report only retail sales on this line.)
2
Deductible gallons
a
Write the number of gallons of motor fuel you sold to organizations
2a
__________________
that are exempt from paying County Motor Fuel Tax.
b
Other deductible gallons allowed by law
2b
__________________________)
__________________
(Description
Number of gallons
3
3
Total deductible gallons (Add Line 2a and Line 2b.)
___________________
4
4
Taxable gallons (Subtract Line 3 from Line 1.)
___________________
Round to the nearest dollar.
Step 2: Figure your net tax and discount
5
5
Tax due (Multiply Line 4 by 4 cents ($.04).)
$__________________
6
6
If you fi led and paid by the due date, multiply Line 5 by 1.75% (.0175).
$__________________
7
7
Net CMFT due (Subtract Line 6 from Line 5.)
$__________________
8
8
Excess CMFT collected
$__________________
9
9
Total tax due (Add Line 7 and Line 8.)
$__________________
Step 3: Figure your payment due
10
10
Credit amount
$__________________
11
11
Payment due (Subtract Line 10 from Line 9.)
$__________________
Make your check payable to “Illinois Department of Revenue”.
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:
County Motor Fuel Tax, Illinois Department of Revenue, PO Box 19034, Springfi eld, IL 62794-9034
This form is authorized by the County Motor Fuel Tax Law. Disclosure of this information is REQUIRED. Failure to provide it could result
in penalty. This form has been approved by the Forms Management Center.
IL-492-2249
CMFT-1 (R-11/09)
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