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2. 
5. Reporting Period*
7. Name of Business:*
9. Mailing Address:*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Fax
18. Illinois Sales Tax #*
19. FEIN #*

21.                                                                                      Calculation of Taxes Due:

24. 1. Gross Sales (Should agree with IL ST-1, Line 3)
27. 2. Deductions of Sales Not Subject to Tax (T-Shirts, etc.)
30. 3. Taxable Sales (Line 1 minus Line 2)
33. 4. Amount of Tax (Multiply Line 3 by 2% (.02)
36. 5. Commission if Pain on Time (Multiply Line 4 by 1% (.01)
39. 6. Total Payment Due (Line 4 minus Line 5)

41. Please make checks payable to the VILLAGE OF NORTH RIVERSIDE and mail your return and tax payment to 2401 s Desplaines Avenue North Riverside Illinois 60546.

    Under penalties as provided by law, I declare that to the best of my knowledge and belief, the information on this return is true, correct and complete. 

43. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
45. Electronic Signature*
47. Name and Title *
48. Email Address*

50.                                         TAXES MUST BE PAID NO LATER THEN 20 DAYS AFTER REPORTING PERIOD 

Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field