Form Pst-1-X - Amended Prepaid Sales Tax Return
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1
2Illinois Department of Revenue
PST-1-X
Amended Prepaid Sales Tax Return
Rev 02 Form 035 Stations 435, 436
E S __ __/__ __/__ __ __ __
Read this information fi rst
NS
DP
CA
RC
Do not write above this line.
•
If you are making a payment with this return,
$___________________________
write the amount you are paying here.
Make your check payable to “Illinois Department of Revenue.”
•
If you are claiming an overpayment on this return and you collected the overpaid tax from your customer(s), you must re-
fund the tax to your customer(s) before fi ling this return. When you complete this return, you must state, under penalties of
perjury, in Step 4, that you unconditionally refunded the overpaid tax to your customer(s).
Step 1: Identify your business
1
Account ID: ____ ____ ____ ____ - ____ ____ ____ ____
2
Reporting period you are amending:
__ __/__ __/__ __ __ __ through __ __/__ __/__ __ __ __
Month Day
Year
Month Day
Year
3
Business name ___________________________________________________________
Step 2: Mark the reason(s) why you are fi ling an amended return
1
3
____ My customer returned gasohol or other motor fuel.
____ I made a computational error.
2
____ I am decreasing Line 1 or I am increasing Line 2 on my
4
original return because I sold gallons
____ I put an amount on the wrong line on either Form PST-1 or
a
____ to a federal or foreign government or to a
Form PST-2.
mass transit system. Write the tax-exempt no.
5
E -____________________________________.
____ I took a deduction on my original return that was
b
____ to an out-of-state customer, which was a sale
not allowed or was too large.
in interstate commerce. The merchandise was
6
delivered to a location outside Illinois.
____ The original account ID was incorrect. The
c
____ to another licensed Illinois distributor or supplier.
correct account ID is ______________________________.
Write the account ID _____________________.
d
7
____ to the state or to units of local government. Write
____ The original reporting period was incorrect. The
the tax-exempt no. E -____________________.
correct reporting period is ___________________________.
e
____ to schools, churches, or charities. Write the tax-
8
exempt no. E -_________________________.
____ Other. Please explain. ______________________________
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
____ 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 percent biodiesel) on or after July 1, 2003.
_______________________________________________
h
____ to other than a retail outlet and delivered the
_______________________________________________
gasohol or other motor fuel to a company-owned
_______________________________________________
(not leased) retail outlet.
_______________________________________________
Please turn this page to complete Steps 3 and 4.
This form is authorized by the Retailers’ Occupation Tax and related tax
acts.
Disclosure of this information is REQUIRED.
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center. IL-492-3869
*003521110*
PST-1-X front (R-8/10)
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