Form 963 Schedule MC-3 "Medical Cannabis Deductions" - Illinois

What Is Form 963 Schedule MC-3?

This is a legal form that was released by the Illinois Department of Revenue - a government authority operating within Illinois. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on May 1, 2015;
  • The latest edition provided by the Illinois Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 963 Schedule MC-3 by clicking the link below or browse more documents and templates provided by the Illinois Department of Revenue.

ADVERTISEMENT
ADVERTISEMENT

Download Form 963 Schedule MC-3 "Medical Cannabis Deductions" - Illinois

549 times
Rate (4.7 / 5) 38 votes
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
REV 01
FORM 963
MC-3
Medical Cannabis Deductions
Page _____ of _____
Attach Schedule MC-3 to Form MC-1, Medical Cannabis Cultivation Privilege Tax Return.
Account ID: ___ ___ ___ ___ ___ ___ ___ ___
License no.: MC - ___ ___ ___ ___ ___
Reporting period: ___ ___ / ___ ___ ___ ___
Month
Year
See Specific Instructions before completing the information below.
Cultivation center’s information
Location code of accepting cultivation center ___ ___ ___ - ___ ___ ___ ___ - ___ - ___ ___ ___
Dispensing organization’s information
Account ID
___ ___ ___ ___ - ___ ___ ___ ___
Registry ID number ___ ___ - ___ ___ ___
Business name
_____________________________________________________________________________________
Physical address
_____________________________________________________________________________________
Number and street
City
State
ZIP
Reason for deduction and invoice number
(See instructions.)
Reason(s)
______________________________________________________________________________________
Invoice number(s) ______________________________________________________________________________________
Figure your deductions
Deductible ounces for this dispensing organization
1b
1b _____________________
Number of deductible bulk ounces
2b
2b _____________________
Number of deductible ounces infused into products
Deductible consideration for this dispensing organization
4b
4b _____________________
Deductible consideration for bulk ounces
5b
5b _____________________
Deductible consideration for ounces infused into products
Cultivation center’s information
Location code of accepting cultivation center ___ ___ ___ - ___ ___ ___ ___ - ___ - ___ ___ ___
Dispensing organization’s information
Account ID
___ ___ ___ ___ - ___ ___ ___ ___
Registry ID number ___ ___ - ___ ___ ___
Business name
_____________________________________________________________________________________
Physical address
_____________________________________________________________________________________
Number and street
City
State
ZIP
Reason for deduction and invoice number
(See instructions.)
Reason(s)
______________________________________________________________________________________
Invoice number(s) ______________________________________________________________________________________
Figure your deductions
Deductible ounces for this dispensing organization
1b
1b _____________________
Number of deductible bulk ounces
2b
2b _____________________
Number of deductible ounces infused into products
Deductible consideration for this dispensing organization
4b
4b _____________________
Deductible consideration for bulk ounces
5b
5b _____________________
Deductible consideration for ounces infused into products
Page totals
1b _____________________
2b _____________________
4b _____________________
5b _____________________
496301110
Reset
Print
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.
MC-3 (N-05/15)
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
REV 01
FORM 963
MC-3
Medical Cannabis Deductions
Page _____ of _____
Attach Schedule MC-3 to Form MC-1, Medical Cannabis Cultivation Privilege Tax Return.
Account ID: ___ ___ ___ ___ ___ ___ ___ ___
License no.: MC - ___ ___ ___ ___ ___
Reporting period: ___ ___ / ___ ___ ___ ___
Month
Year
See Specific Instructions before completing the information below.
Cultivation center’s information
Location code of accepting cultivation center ___ ___ ___ - ___ ___ ___ ___ - ___ - ___ ___ ___
Dispensing organization’s information
Account ID
___ ___ ___ ___ - ___ ___ ___ ___
Registry ID number ___ ___ - ___ ___ ___
Business name
_____________________________________________________________________________________
Physical address
_____________________________________________________________________________________
Number and street
City
State
ZIP
Reason for deduction and invoice number
(See instructions.)
Reason(s)
______________________________________________________________________________________
Invoice number(s) ______________________________________________________________________________________
Figure your deductions
Deductible ounces for this dispensing organization
1b
1b _____________________
Number of deductible bulk ounces
2b
2b _____________________
Number of deductible ounces infused into products
Deductible consideration for this dispensing organization
4b
4b _____________________
Deductible consideration for bulk ounces
5b
5b _____________________
Deductible consideration for ounces infused into products
Cultivation center’s information
Location code of accepting cultivation center ___ ___ ___ - ___ ___ ___ ___ - ___ - ___ ___ ___
Dispensing organization’s information
Account ID
___ ___ ___ ___ - ___ ___ ___ ___
Registry ID number ___ ___ - ___ ___ ___
Business name
_____________________________________________________________________________________
Physical address
_____________________________________________________________________________________
Number and street
City
State
ZIP
Reason for deduction and invoice number
(See instructions.)
Reason(s)
______________________________________________________________________________________
Invoice number(s) ______________________________________________________________________________________
Figure your deductions
Deductible ounces for this dispensing organization
1b
1b _____________________
Number of deductible bulk ounces
2b
2b _____________________
Number of deductible ounces infused into products
Deductible consideration for this dispensing organization
4b
4b _____________________
Deductible consideration for bulk ounces
5b
5b _____________________
Deductible consideration for ounces infused into products
Page totals
1b _____________________
2b _____________________
4b _____________________
5b _____________________
496301110
Reset
Print
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.
MC-3 (N-05/15)