Permanent Location 3:
DBA name:____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers Apt. or suite no.
_____________________________________________
City State ZIP
County:_______________________________________________
If in Madison or St. Clair county, list township: _________________
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Check all of your activities at this location:
Retail sales Aviation Fuel
Vehicles: Sales Renting/leasing
Check if your rental/lease agreements are for more than12 months:
Hotel room rental to the public for periods less than 30 days.
Do you charge for telecommunication services? ___yes ___no
Other: ______________________________________________
Permanent Location 4:
DBA name:____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers Apt. or suite no.
_____________________________________________
City State ZIP
County:_______________________________________________
If in Madison or St. Clair county, list township: _________________
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Check all of your activities at this location:
Retail sales Aviation Fuel
Vehicles: Sales Renting/leasing
Check if your rental/lease agreements are for more than12 months:
Hotel room rental to the public for periods less than 30 days.
Do you charge for telecommunication services? ___yes ___no
Other: ______________________________________________
Illinois Department of Revenue
Schedule REG-1-L Illinois Business Site Location Information
Attach to Form REG-1
Business name: _________________________________________ FEIN: ______ - __________________
Contact for this schedule:_________________________________ SSN: _________ - ______ - ____________
(Proprietorship only)
Phone: (_____) ______ - ___________
Permanent Location 1:
DBA name:____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers Apt. or suite no.
_____________________________________________
City State ZIP
County:_______________________________________________
If in Madison or St. Clair county, list township: _________________
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Check all of your activities at this location:
Retail sales Aviation Fuel
Vehicles: Sales Renting/leasing
Check if your rental/lease agreements are for more than12 months:
Hotel room rental to the public for periods less than 30 days.
Do you charge for telecommunication services? ___yes ___no
Other: ______________________________________________
Permanent Location 2:
DBA name:____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers Apt. or suite no.
_____________________________________________
City State ZIP
County:_______________________________________________
If in Madison or St. Clair county, list township: _________________
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Check all of your activities at this location:
Retail sales Aviation Fuel
Vehicles: Sales Renting/leasing
Check if your rental/lease agreements are for more than12 months:
Hotel room rental to the public for periods less than 30 days.
Do you charge for telecommunication services? ___yes ___no
Other: ______________________________________________
174530101
IL
IL
IL
IL
REG-1-L front (R-11/17)
Step 1: Identify each permanent location.
Read this information first.
Complete Schedule REG-1-L, to identify all Illinois locations from which you will make retail sales, rent/lease vehicles, and/or rent or lease hotel rooms to the
public for periods of less than 30 days. You must also identify the same location you did on Form REG-1, Line 4, if the activities at that location include retail
sales or rental/leases. In Illinois some tax rates vary based upon the specific location of the business activities. The location of your business will determine the
tax rate that we will preprint on your return. We recognize three types of locations:
Permanent - Examples include a building, warehouse, or storefront. To identify these, complete Step 1.
Changing - A changing location is one that constantly changes (e.g., door-to-door sales, home party sales). If you have changing locations, complete
Step 2. You must identify sales from a vending machine as a changing location.
Temporary - Examples include a fair, festival, or convention. To identify temporary locations, complete Step 3. Special events or seasonal sales should
also complete Step 3.
To identify more locations, attach a sheet using a similar format. If you have previously registered and need to add a location, call us at 217 785-3707.
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.
Printed by the Authority of the State of Illinois (web only)
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