Form Cmft-2 - Multiple-Site Form - 1998
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Illinois Department of Revenue
CMFT-2
Multiple-Site Form (Attach to Form CMFT-1)
Rev
Form
__________________
IBT no.:__ __ __ __ - __ __ __ __ Liability period:____________
Do not write above this line.
Owner’s name____________________________________________
Column A
Column B
Business name___________________________________________ Number of taxable gallons
Amount of tax
You must round your figures to whole dollars. See instructions.
Site where the taxable retail sale was made:
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Location code
_____________________________________
(4) ______________
X
=
(5) ______________
Site name
_____________________________________
Site address
_____________________________________
_____________________________________
City, state, ZIP
_____________________________________
Column totals (See instructions for multiple pages.)
______________
______________
Write the total of this
Write the total of this
column on Line 4 of
column on Line 5 of
Form CMFT-1.
Form CMFT-1.
This form is authorized by the County Motor Fuel Tax law. Disclosure of this information is REQUIRED. Failure to provide information could result in penalty. This form has been approved by the Forms
Management Center.
IL-492-2250
CMFT-2 (R-9/98)
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