Form Pst-1-X - Amended Prepaid Sales Tax Return - Illinois Department Of Revenue
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1
2Illinois Department of Revenue
PST-1-X
Amended Prepaid
Sales Tax Return
Rev 01 Form 035 Stations 435, 436
E S _ _/_ _/_ _ _ _
NS DP CA RC
Do not write above this line.
Read this information first
Everyone must complete Parts 1, 2, and 5.
You must also complete
Amount you are paying: $ _________________
• Part 3 if you believe you have overpaid, and
Make your check payable to “Illinois Department of Revenue.”
• Part 4 if you are changing financial information.
Part 1: Identify your business
“X” only if your address is different from the address on your
1
IBT no. ____ ____ ____ ____ - ____ ____ ____ ____
Illinois business tax number
original return and complete Line 4 below.
2
4
Amended tax period ____________________________________
Mailing address ________________________________________
Number and street
3
Business name_________________________________________
_______________________________________________________
City
State
ZIP
Part 2: Check the reason you are correcting your return
1 __
3 __
__ My customer returned gasohol or other motor fuel.
__ I made a computational error.
2 _
4 __
___ I should have taken a deduction or a larger deduction on my
__ I put an amount on the wrong line on either Form PST-1 or
original return because I sold gasohol or other motor fuel
Form PST-2.
a
____ to a federal or foreign government or to a
5 _
mass transit system.
___ I took a deduction on my original return that was
(tax exempt no. E -__ __ __ __ - __ __ __ - __ __)
not allowed or was too large.
b
____ to an out-of-state customer, which was a sale
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in interstate commerce. The merchandise was
____ The original IBT number was incorrect. The
delivered to a location outside Illinois.
correct IBT number is ___ ___ ___ ___- ___ ___ ___ ___.
c
____ to another licensed Illinois distributor or supplier.
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(IBT no. ___ ___ ___ ___- ___ ___ ___ ___)
____ The original tax period was incorrect. The
d
____ to the state or to units of local government.
correct tax period is _______________________________.
(tax exempt no. E -__ __ __ __ - __ __ __ - __ __)
e
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____ to schools, churches, or charities.
____ Other. Please explain. ______________________________
(tax exempt no. E -__ __ __ __ - __ __ __ - __ __)
________________________________________________
f
____ to an out-of-state retailer who is authorized to do
________________________________________________
business out-of-state and who resells at retail and
________________________________________________
delivers to customers outside Illinois.
________________________________________________
g
____ to other than a retail outlet and delivered the
________________________________________________
gasohol or other motor fuel to a company-owned
________________________________________________
(not leased) retail outlet.
Part 3: If you are claiming an overpayment, you must answer the following
1
Did you collect the overpaid tax from your customer?
____ yes ____ no
2
If yes, did you unconditionally refund the overpaid tax?
____ yes ____ no
Please turn page over to complete Parts 4 and 5
This form is authorized by the Retailers’ Occupation Tax and related tax
acts.
Disclosure of this information is REQUIRED.
PST-1-X front (N-7/98)
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center. IL-492-3869
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