Form RCR-16 Request for Transfer of Credit Memorandum - Illinois

Form RCR-16 is a Illinois Department of Revenue form also known as the "Request For Transfer Of Credit Memorandum". The latest edition of the form was released in April 1, 2010 and is available for digital filing.

Download an up-to-date Form RCR-16 in PDF-format down below or look it up on the Illinois Department of Revenue Forms website.

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Use your 'Mouse' or the 'Tab key' to move through the fields and 'Mouse' or 'Space bar' to enable the checkboxes.
Illinois Department of Revenue
Request for Transfer of Credit Memorandum
OFFICIAL USE ONLY
The fi ling of this form is required by the Illinois Department of Revenue in order to transfer a Credit
License Number
Memorandum to a registration number other than that to which the credit was originally issued.
SECTION I — Credit Memorandum To Be Transferred
1
7
Business name
Credit Memorandum number
2
8
Owner(s), corporate name if owner is a corporation
License number
3
9
Number and street address
Date Credit Memorandum issued
4
5
6
10
City
State
ZIP code
Amount of Credit Memorandum
SECTION II — Transfer Credit Memorandum To
OFFICIAL USE ONLY
11
License number
LIC.
NO.
12
Business name
LOC.
CODE:
13
Owner(s), corporate name if owner is a corporation
CREDIT
MEMO
NO.:
14
Number and street address
DATE
ISSUED
15
16
17
City
State
ZIP code
AMOUNT $
SECTION III — Signature Affi davit of Seller
To be completed by the business in whose name the Credit Memorandum was originally issued.
PROPRIETORSHIP OR PARTNERSHIP - Line 18; CORPORATION - Lines 19 & 20
Mail Excise Tax requests to:
I realize that the Illinois Department of Revenue must apply the attached Credit Memorandum to
any outstanding liability I might have. The remaining balance, if any, will then be transferred.
EXCISE TAXES DIVISION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19477
18
SPRINGFIELD IL 62794-9477
Signature of owner or partner
date
19
Signature of offi cer of corporation
date
20
Title
This form is authorized as outlined by the Retailer's Occupation Tax and Related Tax Acts. Disclosure of this
information is REQUIRED. Failure to provide information could result in penalties. This form has been
*091601110*
approved by the Forms Management Center. IL-492-1370
RCR-16 (R-04/10)
Reset
Print
Use your 'Mouse' or the 'Tab key' to move through the fields and 'Mouse' or 'Space bar' to enable the checkboxes.
Illinois Department of Revenue
Request for Transfer of Credit Memorandum
OFFICIAL USE ONLY
The fi ling of this form is required by the Illinois Department of Revenue in order to transfer a Credit
License Number
Memorandum to a registration number other than that to which the credit was originally issued.
SECTION I — Credit Memorandum To Be Transferred
1
7
Business name
Credit Memorandum number
2
8
Owner(s), corporate name if owner is a corporation
License number
3
9
Number and street address
Date Credit Memorandum issued
4
5
6
10
City
State
ZIP code
Amount of Credit Memorandum
SECTION II — Transfer Credit Memorandum To
OFFICIAL USE ONLY
11
License number
LIC.
NO.
12
Business name
LOC.
CODE:
13
Owner(s), corporate name if owner is a corporation
CREDIT
MEMO
NO.:
14
Number and street address
DATE
ISSUED
15
16
17
City
State
ZIP code
AMOUNT $
SECTION III — Signature Affi davit of Seller
To be completed by the business in whose name the Credit Memorandum was originally issued.
PROPRIETORSHIP OR PARTNERSHIP - Line 18; CORPORATION - Lines 19 & 20
Mail Excise Tax requests to:
I realize that the Illinois Department of Revenue must apply the attached Credit Memorandum to
any outstanding liability I might have. The remaining balance, if any, will then be transferred.
EXCISE TAXES DIVISION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19477
18
SPRINGFIELD IL 62794-9477
Signature of owner or partner
date
19
Signature of offi cer of corporation
date
20
Title
This form is authorized as outlined by the Retailer's Occupation Tax and Related Tax Acts. Disclosure of this
information is REQUIRED. Failure to provide information could result in penalties. This form has been
*091601110*
approved by the Forms Management Center. IL-492-1370
RCR-16 (R-04/10)
Reset
Print

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