Business DBA Name/Local Address
Reporting Period___________/ __ __ __ __
______________________________________________
Month Year
______________________________________________
Illinois Business Tax (IBT) #
______________________________________________
__ __ __ __ - __ __ __ __
Or Employer Identification Number (EIN)
__ __- __ __ __ __ __ __ __
Corporate Name/Mailing Address (if different)
*If reporting multiple locations on one tax return, you must
______________________________________________
attach Multiple Location Reporting form LMFTR2.
______________________________________________
______________________________________________
Computation of Local Motor Fuel Tax Liability Column 1 Column 2
Non-Diesel Diesel
1
Total gallons (sold if retailer/purchased if bulk user)
*
2 Tax rate per gallon $0.05 $0.01
3 Multiply line 1 times rate on line 2
4 Subtotal (add Line 3, Columns 1 and 2)
5
Prompt Payment Compensation – Deduct 1.75% (multiply line 4 times .0175)
-
If filed and paid by the 20
th
of the month for the previous month
6
Penalty for late payment (multiply line 4 times 10% per month) # of Months
If paid after the 20
th
of the month for the previous month
7
Total Tax to be remitted
______________________________________ ______________________________________
Signature of Taxpayer Signature of Preparer
______________________________________ ______________________________________
______________________ ________________ ______________________ ________________
Date Signed Telephone Number Date Prepared Telephone Number
Make Check Payable To: City of Decatur
Mail this completed and signed return along with payment for the amount shown on line 7 to:
City of Decatur Questions? Call 217-424-2854
#1 Gary K Anderson Plaza City website and tax forms:
Decatur, IL 62523
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.
Local Motor Fuel Tax Return
Pursuant to Decatur City Code Chapter 51.4
