Form Pst-1-X - Amended Prepaid Sales Tax Return Page 2
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1
2Part 4: Correct your financial information
Column A
Column B
Complete this section only if you are changing financial information.
Most recent figures filed
Figures as they should
Please round to the nearest whole dollar.
have been filed
Section 1: Report your gallonage information
1
Write the total invoiced gallons of all gasohol and other motor fuel
1
1
you sold, delivered, or transferred.
____________
____________
(05)
2
Write the total deductible gallons
a
2a
2a
____________
____________
sold to federal or foreign governments or mass transit systems.
(10)
b
2b
____________
2b
____________
delivered outside Illinois.
(15)
c
2c
____________
2c
____________
sold and distributed tax-free to other licensed distributors and suppliers.
(20)
d
2d
2d
sold to the state or other units of local government.
____________
(25)
____________
e
2e
____________
2e
____________
sold to schools, churches, or charities.
(30)
f
2f
____________
2f
____________
sold to out-of-state retailers who sell at retail to customers outside of Illinois.
(40)
g
of exempt motor fuel ( i.e. , majority-blended ethanol, 100 percent biodiesel,
and biodiesel blends that are more than 10 percent but not more than 99
2g
2g
percent biodiesel) on or after July 1, 2003.
____________
____________
(43)
h
sold to other than a retail outlet and delivered to a company-owned
2h
____________
2h
____________
(not leased) retail outlet.
(45)
3
3
3
Add Lines 2a through 2h. This amount is your total deductible gallons.
____________
(50)
____________
4
Subtract Line 3 from Line 1.
4
____________
4
____________
This amount is your net gallons subject to prepaid sales tax.
(55)
a
.)
4a
4a
Gallons of gasohol subject to prepaid sales tax. (See instructions
____________
(90)
____________
b
4b
____________
4b
____________
Gallons of other motor fuel subject to prepaid sales tax. (See instructions.)
(91)
Section 2: Figure your payment
5
Multiply the number of gallons on Line 4a by
$0.05 (for liability periods beginning July 1, 2003) or
$0.03 (for liability periods before July 1, 2003).
5
____________
5
____________
(92)
6
Multiply the number of gallons on Line 4b by
$0.06 (for liability periods beginning July 1, 2003) or
6
6
$0.04 (for liability periods before July 1, 2003).
____________
____________
(93)
7
Add Lines 5 and 6. This is your total prepaid sales tax due during this
7
____________
7
____________
reporting period.
(56)
8
Write the amount of quarter-monthly payments paid on Form PST-3. If you
8
____________
8
____________
do not file quarter-monthly payments, write zero.
(61)
Write any PST prior overpayment amount that you are using.
9
9
____________
9
____________
(85)
10
10
10
Subtract Lines 8 and 9 from Line 7. This is the net tax due.
____________
(62)
____________
Write the PST credit memorandum amount you are using.
11
11
11
____________
____________
You must attach the original PST credit memorandum.
(76)
12
12
____________
12
____________
Subtract Line 11 from Line 10. This is the tax due.
(77)
13
Write the total amount you have paid.
13
____________
Compare Line 12, Column B, and Line 13.
• If Line 13 is greater than Line 12, Column B, write the difference on Line 14.
• If Line 13 is less than Line 12, Column B, write the difference on Line 15.
14
Overpayment — This is the amount you have overpaid. Go to Line 16.
14
____________
15
Underpayment — This is the amount you have underpaid. Please pay this amount.
Make your check payable to “Illinois Department of Revenue.” Go to Line 16.
15
____________
16
Write the total number of PST-2 forms you have attached
16
____________
to all PST-1 forms you have filed for this liability period.
(80)
Go to Part 5 and sign this return.
Part 5: 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.
(
)
Owner, partner, or officer’s signature
Title
Phone
Date
(
)
Paid preparer’s signature
Title
Phone
Date
Mail to:
ILLINOIS DEPARTMENT OF REVENUE
Please write the amount you are paying on the
line provided in the "Read this information
PO BOX 19034
first" section on the front of this return.
SPRINGFIELD IL 62794-9034
PST-1-X (R-9/03)
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