Pst-1 8/10 - Prepaid Sales Tax Return - Illinois
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Illinois Department of Revenue
PST-1
Prepaid Sales Tax Return
Rev 02 Form 033
E S
_ _/ _ _/ _ _ _ _
NS DP CA RC
Do not write above this line.
Account ID: ______________________ Reporting Period: ______________________________________
Owner’s name:
_________________________________________________________________________
Business name: _________________________________________________________________________
Mailing address: _________________________________________________________________________
_________________________________________________________________________
Step 1: Figure your gallonage information
1
Total invoiced gallons of all gasohol and other motor fuel sold, delivered, or transferred
1 ______________________
2
Write the number of gallons you
a sold to federal or foreign government and mass transit systems.
2a ______________________
b delivered outside Illinois.
2b ______________________
c sold and distributed tax free to other licensed distributors or suppliers.
2c ______________________
d sold to the state or units of local government.
2d ______________________
e sold to schools, churches, or charities.
2e ______________________
f sold to out-of-state retailers selling at retail to customers outside Illinois.
2f ______________________
g sold of exempt motor fuel (see instructions).
2g ______________________
h sold to other than a retail outlet and deliveries made to your
company-owned (not leased) retail outlet.
2h ______________________
(Do not include gallonage written on Lines 2a through 2g.)
3
Total deductible gallons (Add Lines 2a through 2h.)
3 ______________________
4
Net gallons subject to prepaid sales tax (Subtract Line 3 from Line 1. )
4 ______________________
a Gallons of gasohol and biodiesel blends (1% - 10%) subject to prepaid sales tax
(This is the total of Lines 8a of your attached PST-2 forms.)
4a______________________
b Gallons of all other motor fuels subject to prepaid sales tax
(This is the total of Lines 9a of your attached PST-2 forms.)
4b ______________________
Step 2: Figure your tax and payment due
.
5
Multiply the number of gallons on Line 4a by ________.
5 $______________
______
.
(rate)
6
Multiply the number of gallons on Line 4b by ________.
6 $______________
______
.
(rate)
7
Total prepaid sales tax due during this reporting period (Add Lines 5 and 6.)
7 $______________
______
8
Write the amount of quarter-monthly payments that you
.
paid on Form PST-3 or by EFT.
8 $______________
______
.
9
Credit amount.
9 $______________
______
.
10
Total quarter-monthly payments and credits (Add Lines 8 and 9.)
10 $______________
_____
.
11
Payment due (Subtract Line 10 from Line 7.)
11 $______________
______
Make your check payable to Illinois Department of Revenue.
12
Write the number of PST-2 forms you have attached.
12 ______________________
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.
_________________________________________________________________________/____/_____
Taxpayer’s signature
Phone
Date
_________________________________________________________________________/____/_____
Preparer’s signature
Phone
Date
Mail your completed return and payment to:
Illinois Department of Revenue, PO Box 19034, Springfi eld, IL 62794-9034
This form is authorized by the Retailers’ Occupation Tax Act. 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-492-1334
PST-1 (R-08/10)
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