Form IDR-277-C Claim for Refund - Single Trip Interstate Motor Fuel Use Tax Permit - Illinois

Form IDR-277-C is a Illinois Department of Revenue form also known as the "Claim For Refund - Single Trip Interstate Motor Fuel Use Tax Permit". The latest edition of the form was released in April 1, 2010 and is available for digital filing.

Download a PDF version of the Form IDR-277-C down below or find it on Illinois Department of Revenue Forms website.

ADVERTISEMENT
Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.
Illinois Department of Revenue
Claim for Refund
IDR-277-C
Single Trip Interstate Motor Fuel Use Tax Permit
Who should fi le this form?
Approved permit providers must complete Form IDR-277-C to receive a refund for voided Single Trip Interstate Motor Fuel Use Tax Permits
returned to the Illinois Department of Revenue. A separate claim must be fi led for each permit that has been returned.
Where do I send my completed Form IDR-277-C?
Mail your completed Form IDR-277-C and voided permit to
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19018
SPRINGFIELD IL 62794-9018
Step 1: Identify your business
__ __ __ __ __ __ __ __
Account ID:
ST - __ __ __ __ __
License no.:
Name:
_______________________________________________
Address: _______________________________________________
City:______________________________
ZIP:________________
Step 2: Check all that apply to the reason you are completing this claim
1
_____ Typed the wrong information on the permit.
2
_____ Discovered the driver did not need permit after it was issued.
3
_____ Issued for incorrect state or agency.
4
_____ Other - Describe the situation. Attach additional sheets if needed.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Step 3: Figure your claim amount
5
Write the voided permit number:___________________________
You must attach it to this claim.
$40.00
6
Permit fee to be refunded:
Step 4: Sign below
I certify that, to the best of my knowledge, the information on this claim for refund is true and accurate and that I am seeking a refund for
payment of a permit that was never issued, but was voided for the reason indicated above.
Offi cial Use
_______________________________________________
___ ___/___ ___/___ ___ ___ ___
No
____________
Signature
Date
Amt
____________
Apv
____________
Vrf
____________
*092201110*
DR
____________
Int D
____________
IDR-277-C (R-04/10)
This form is authorized by the Motor Fuel Tax Law. Disclosure of information is REQUIRED. Failure to comply
IL-492-4593
may result in a penalty. This form has been approved by the Forms Management Center.
Reset
Print
Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.
Illinois Department of Revenue
Claim for Refund
IDR-277-C
Single Trip Interstate Motor Fuel Use Tax Permit
Who should fi le this form?
Approved permit providers must complete Form IDR-277-C to receive a refund for voided Single Trip Interstate Motor Fuel Use Tax Permits
returned to the Illinois Department of Revenue. A separate claim must be fi led for each permit that has been returned.
Where do I send my completed Form IDR-277-C?
Mail your completed Form IDR-277-C and voided permit to
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19018
SPRINGFIELD IL 62794-9018
Step 1: Identify your business
__ __ __ __ __ __ __ __
Account ID:
ST - __ __ __ __ __
License no.:
Name:
_______________________________________________
Address: _______________________________________________
City:______________________________
ZIP:________________
Step 2: Check all that apply to the reason you are completing this claim
1
_____ Typed the wrong information on the permit.
2
_____ Discovered the driver did not need permit after it was issued.
3
_____ Issued for incorrect state or agency.
4
_____ Other - Describe the situation. Attach additional sheets if needed.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Step 3: Figure your claim amount
5
Write the voided permit number:___________________________
You must attach it to this claim.
$40.00
6
Permit fee to be refunded:
Step 4: Sign below
I certify that, to the best of my knowledge, the information on this claim for refund is true and accurate and that I am seeking a refund for
payment of a permit that was never issued, but was voided for the reason indicated above.
Offi cial Use
_______________________________________________
___ ___/___ ___/___ ___ ___ ___
No
____________
Signature
Date
Amt
____________
Apv
____________
Vrf
____________
*092201110*
DR
____________
Int D
____________
IDR-277-C (R-04/10)
This form is authorized by the Motor Fuel Tax Law. Disclosure of information is REQUIRED. Failure to comply
IL-492-4593
may result in a penalty. This form has been approved by the Forms Management Center.
Reset
Print

Download Form IDR-277-C Claim for Refund - Single Trip Interstate Motor Fuel Use Tax Permit - Illinois

849 times
Rate
4.7(4.7 / 5) 51 votes
ADVERTISEMENT