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Illinois Department of Revenue
REG-9
Telecommunication Tax Service Information
Read this information first
Page ____ of ____
You must identify each municipality where you provide telecommunication service. If you provide service to customers you know are not
located within a municipality, you may list in Step 3, the county or counties where you provide that service. Refer to RT-8, Telecommunication
Tax Rate Reference Manual, to assist you. Your Form REG-9 information allows us to preprint your Forms RT-2, Telecommunications Tax
Return and RT-2-M, Telecommunication Tax Schedule (for service providers with customers in multiple municipalities). If you need more
space than provided for here, make a copy of Form REG-9 and identify each page in the upper right corner.
Step 1:
Identify your business
a
d
T -
Business name: ________________________________________
License no.:
__________________
b
e
DBA: ________________________________________________
Illinois Business Tax number (IBT no.): __ __ __ __ - __ __ __ __
c
f
Contact person's information: Telephone: __________-_________
Address:______________________________________________
City, State, ZIP: ________________________________________
Name: _______________________________________________
Step 2:
Identify the municipality where you provide telecommunication service
(Required)
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Municipality name: ___________________________________________________________
Code: ___ ___ ___ - ___ ___ ___ __ - ___
Step 3:
Identify the county where you provide telecommunication service
(Optional)
You may list the county or counties in which you provide service to customers that you know are not located within a municipality. We will
send you a preprinted Form RT-2-M, that will list both the municipalities and counties you have provided on Form REG-9, and each tax rate.
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
County name:___________________________________________
Code:___ ___ ___ - ___ ___ ___ __ - ___
Step 4:
Mail your Form REG-9
Mail Form REG-9 to :
MISCELLANEOUS TAXES DIVISION
RESET
PRINT
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19039
SPRINGFIELD IL 62794-9039
This form is authorized as outlined by the Telecommunications Excise Tax and Simplified Municipal Telecommunications Tax Acts. Disclosure of this information
REG-9 (N-12/02)
is REQUIRED. Failure to provide information could result in a fine. This form has been approved by the Forms Management Center.
IL-492-4333