STATUS [ ] For office use only

Transcription

1 CITY OF CHICAGO DEPARTMENT OF REVENUE VEHICLE FUEL TAX STATUS [ ] For office use only ACCOUNT NUMBER DUE DATE CHECK IF RETURN IS: Mail Payment and Return to: Amended BEGINNING PERIOD ENDING PERIOD MAILING ADDRESS: Number of Sites: BUSINESS ADDRESS: BUSINESS PHONE Check the following if deposits were: Estimate Actual (If actual, annualization schedule must be attached) If you have any changes to the account information listed on this return please contact Client Consultation of the Department of Revenue at (312) 747-IRIS (4747). Do not fill in cents amount, round up to nearest dollar (if 50 cents or more). Check and complete one of the following: Distributor Retailer User/Purchaser 1. Inventory of vehicle fuel at the beginning of the period Vehicle fuel produced, acquired, or received during the period Total available for sale Deductions (line 4j of instructions) Taxable vehicle fuel (subtract line 4 from line 3) Applicable tax rate Tax due before credit (multiply line 5 by line 6)... STOP AT LINE 7 IF THIS IS AN AMENDED RETURN Current year's tax payments... Page

2 REVISION NUMBER 9. Tax due (subtract line 8 from line 7). If line 9 is greater than 0, enter the amount owed. If line 9 is less than 0, please skip to line Interest due for late payment (line 10c of instructions) Penalty for late payment/filing (see instructions) Total tax, interest, and penalty due (add lines 9, 10, and 11) Overpayment. If line 9 is less than 0, enter the amount of overpayment. 14. If you want the amount of the overpayment to be credited to next year's estimated tax, check the credit box. Otherwise, check the refund box... Credit Refund NOTE: Any amounts overpaid will first be applied to deficiencies outstanding for this tax and to deficiencies for any other City of Chicago tax for which you are registered. Page

3 REVISION NUMBER MARKING INSTRUCTIONS Use a black or blue ink pen only. Do not use pens with ink that soaks through the paper. Print clearly, using all CAPITAL letters. Owner/Officer Statement Under penalty of perjury, I certify that I have examined this return, and to the best of my knowledge and belief, it is true, correct and complete. FIRST NAME LAST NAME PHONE NUMBER DATE SIGNATURE (REQUIRED) TITLE Preparer Statement Under penalty of perjury, I certify that I have examined this return, and to the best of my knowledge and belief, it is true, correct and complete. FIRST NAME LAST NAME PHONE NUMBER DATE AGENT/PAID PREPARER SIGNATURE (REQUIRED) BUSINESS NAME F.E.I.N. PHONE NOTE: YOU MUST FILL THIS FORM OUT COMPLETELY. IF ANY INFORMATION IS OMITTED, THIS RETURN WILL BE DEEMED INCOMPLETE, AND YOU WILL BE ASSESSED ADDITIONAL PENALTIES. ACCOUNT NUMBER MUST BE ENTERED. For DOR Use Only Postmark Date Receipt Number Page

4 INSTRUCTIONS FOR PREPARING THE VEHICLE FUEL TAX RETURN LINES 1 THROUGH 5 MUST BE ROUNDED TO WHOLE GALLONS. When calculating the amount of gallons, round up to the nearest whole gallon if the quantity is 0.5 or more. Round down to the nearest whole gallon if the quantity is 0.49 or less. LINE 1. LINE 2. Enter the number of gallons of fuel on hand at the close of business on the last day of the preceding period. Fuel means any volatile and inflammable liquid or gas produced, blended, or compounded for the purpose of, or which is suitable for, operating a vehicle or which is used in propelling a vehicle... Enter the number of gallons produced, acquired, received, or gained through temperature variations during the period... LINE 3. Total gallons available for sale (add lines 1 and 2)... LINE 4. a. Enter the deductions as detailed in the following schedule: Sales or use for purposes other than for propulsion or operation of a vehicle... b. Sales or use by the federal government or any state or local government... c. Sales to transportation agencies (must be operated by or through the Regional Transportation Authority)... d. Sales for use by a common air carrier for a flight destination outside the United States... e. Sales to other distributors with valid registration certificates or purchases of vehicle fuel in which Chicago Fuel Tax was paid... f. Sales for delivery outside the City of Chicago... g. h. Losses due to fire, leakage, spillage, etc. (you may be required to substantiate any of these claims with appropriate EPA reports)... Losses due to temperature variations and evaporations (this figure is a balancing figure to account for variations in the accounting figures and the actual measurements. Retain all records)... i. The amount of vehicle fuel held in inventory on the last day of the current period. This amount includes any and all vehicle fuel owned by your business, regardless of location... j. Total deductions (add lines a - i)... LINE 5. LINE 6. LINE 7. Taxable vehicle fuel (subtract line 4 from line 3)... Preprinted tax rate. Total computed tax (multiply line 6 by line 5). Page

5 LINE 8. LINE 9. LINE a. Enter the total amount of all the current year's tax payments you have remitted to the department. Enter total tax due (subtract line 8 from line 7). If line 9 is greater than 0, enter the amount owed. If line 9 is less than 0, skip to line 13. Determine the amount of interest owed based on tax past due. Enter number of days late (August 16 being one day late, etc.)... 10b. Enter the amount from line c. Total amount of interest (10b * [10a / 365]) * 12%... EXAMPLE: If you determine that you owe $100,000 on the due date (August 15) and you file and pay the tax on August 26, then you are 11 days late in making the payment. The calculation of the interest owed is as follows: [$100,000 * (11/365)] * 12% = $ LINE 11. LINE 12. LINE 13. LINE 14. Late penalties: Compute penalty based on 1 of the 2 requirements listed below: a) If return is being filed timely, but payment is late, compute 5% of line 9. b) If return is filed late, compute the greater of 1) 1% of line 7 (up to a maximum of $5,000) or 2) 5% of line 9. The tax return is due on or before the 15th day of the second month following the year in which taxable receipts are received. Enter the total tax, interest and penalty due (add lines 9, 10, and 11). Overpayment. If line 9 is less than 0, enter the amount of overpayment. If you want the amount of the overpayment to be credited to next year's estimated tax, enter a check in the credit box. Otherwise, check the refund box. NOTE: Any amounts overpaid will first be applied to deficiencies outstanding for this tax and to deficiencies for any other City of Chicago tax for which you are registered. FOR ADDITIONAL INFORMATION CALL IRIS (4747) (TTY ) NOTE: YOU MUST COMPLETE ALL INFORMATION ON THIS PAGE FOR THIS RETURN TO BE CONSIDERED COMPLETE. Page

6 Chicago Department of Revenue Annualization Schedule ACCOUNT NUMBER TAX CODE BEGINNING PERIOD ENDING PERIOD Note: Please fill out this form if you meet at least one of the following criteria. 1. You paid or remitted at least $2 million dollars for any given tax type for the preceding annual tax year. 2. Your actual liability for this Annual Return Tax during any three consecutive calendar months of the twelve month period immediately preceding the current Annual Tax Year was greater than 50 percent of your liability for such Annual Return Tax for such entire twelve month period. 3. You are a new business that began after July 1st of the current tax year (an incomplete tax year). 4. You voluntarily elect to pay on an actual basis. 5. You did not remit one or more payment coupons or did not file a return in the twelve-month period immediately preceding the tax year now being filed. Tax Computed Due NOTE: DO NOT ENTER GROSS CHARGE/RECEIPT AMOUNTS. (Before any applicable commission) 1. July August September October November December January February March April May June... Total Tax Computed Due Before Any Applicable Commission. This amount must equal the tax due before commission reported on the tax return. Any difference will be applied to the earliest payment period. Page 1 V