Rev. 0616
Business DBA Name/Location Address Filing Month _______________________________
____________________________________
____________________________________ Illinois Business Tax (IBT) #_________-_________
____________________________________
Owner Name/Mailing Address (if different) * If reporting multiple locations on
____________________________________ one tax return, you must attach
____________________________________ Multiple Location Reporting form.
____________________________________
Computation of Food & Beverage Tax Liability
1. Taxable sales of prepared food and beverage and * _______________________
alcoholic beverages (for most businesses this will be Line 3 of ST-1)
2. 2% Food & Beverage Tax (line 1 x .02) _______________________
3. Prompt Payment Compensation – Deduct 1.75% (line 2 times .0175) ─ ___________________
If filed and paid by the 20
th
of the month for the previous month
4. Penalty for late payment (line 2 times 10% per month) # of Months _______________________
If paid after the 20
th
of the month for the previous month
5. Total Tax to be remitted (Add lines 2 through 4) _______________________
Under penalties as provided by law, I declare that to the best of my knowledge and belief, the
information on this form is true, correct and complete.
______________________________________ ______________________________________
Signature of Taxpayer Signature of Preparer
______________________________________ ______________________________________
Title Company Name
______________________ ________________ ______________________ ________________
Date Signed Telephone Number Date Prepared Telephone Number
DUE: 20th of the month following the filing month.
Make check payable to: City of Decatur
Mail completed and signed tax return along with payment for the amount shown on line 4 to:
City of Decatur Auditor Questions? Call (217) 424-2854
Finance Department City website and tax forms:
#1 Gary K Anderson Plaza www.decaturil.gov
Decatur, IL 62523
