Form Rc-9 - Schedule Cc - Cigarettes And Little Cigars Purchased With Illinois Cigarette Revenue Stamps Affixed To Original Packages

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Illinois Department of Revenue
REV 01 FORM 440
RC-9
Schedule CC
Cigarettes and Little Cigars Purchased with Illinois Cigarette
Revenue Stamps Affixed to Original Packages
Read this information first
Sheet no. __________
Attach a completed original schedule to either Form RC-6, Cigarette and Little Cigar Revenue Return, Form RC-6-A,
Out-of-State Cigarette and Little Cigar Revenue Return, Form RC-6-X, Amended Cigarette and Little Cigar Revenue Return,
or Form RC-6-A-X, Amended Out-of-State Cigarette and Little Cigar Revenue Return.
For additional instructions, see Form RC-6, Form RC-6-X, Form RC-6-A, or Form RC-6-A-X.
Step 1: Identify your business
Name: _ ____________________________________________ Account ID: __ __ __ __ __ __ __ __
Address: ___________________________________________ License no.: ___ - ___ ___ ___ ___ ___
Number and street
__________________________________________________ Tax period: __ __ / __ __ __ __
City
State
ZIP
Month
Year
Step 2: Identify the cigarettes or little cigars you purchased with Illinois stamps
affixed or purchased as returned merchandise from retailers
FEIN of seller
Name and address of seller
Date
Invoice no.
from whom you purchased
from whom you purchased
Number of sticks
cigarettes or little cigars
cigarettes or little cigars
,
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Page total
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Grand total
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*344011110*
RC-9 (R-07/13) Schedule CC
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this
information is required. Failure to provide information may result in this form not being processed and may result in a penalty.

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