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            Illinois Department of Revenue
                                                                                                                                          Rev 03   Form 033
            PST-1 Prepaid Sales Tax Return                                                                                                E    S   _ _/ _ _/ _ _ _ _ 
                                                                                                                                          NS  DP  CA  RC
                                                                                                                                          Do not write above this line.
Account ID: ______________________  Reporting Period: ______________________________________ 
Owner’s name:   _________________________________________________________________________
Business name:    _________________________________________________________________________
Mailing address:   _________________________________________________________________________
                     _________________________________________________________________________
Step 1: Figure your gallonage information and your tax and payment due
1      Total invoiced gallons of all motor fuel sold, delivered, or transferred                                                           1   ______________________
2     Enter the number of gallons you 
      a  sold to federal or foreign government and mass transit systems                     2a  ______________________
      b   delivered outside Illinois                                                        2b  ______________________
      c  sold and distributed tax free to other licensed distributors or suppliers          2c  ______________________
      d  sold to the state or units of local government                                     2d  ______________________
      e  sold to schools, churches, or charities                                            2e  ______________________
    f     sold to out-of-state retailers selling at retail to customers outside Illinois    2f  ______________________
      g  sold of exempt motor fuel (See instructions.)                                      2g  ______________________
      h  sold to other than a retail outlet and deliveries made to your
          company-owned (not leased) retail outlet (Do not include
          gallonage already entered on Lines 2a through 2g.)                                2h  ______________________
3     Total deductible gallons (Add Lines 2a through 2h.)                                                                                 3   ______________________
4     Net gallons subject to prepaid sales tax (Subtract Line 3 from Line 1.)                                                             4   ______________________
      a  Enter the total gallons of gasohol (E15 only) subject to prepaid sales tax from each Line 8a of your
          attached PST-2 forms.                                                                                                           4a ______________________
      b  Enter the total gallons of mid-range ethanol blends subject to prepaid sales tax from each Line 9a
          of your attached PST-2 forms.                                                                                                   4b ______________________
      c  Enter the total gallons of diesel fuel containing 1% - 10% biodiesel or renewable diesel subject to
          prepaid sales tax from each Line 10a of your attached PST-2 forms.                                                              4c ______________________
      d  Enter the total gallons of all other motor fuels subject to prepaid sales tax from each Line 11a
          of your attached PST-2 forms.                                                                                                   4d  ______________________
5     Multiply the number of gallons on Line 4a by ________.                                                                              5   $______________.______
                                                        (rate)
6     Multiply the number of gallons on Line 4b by ________.                                                                              6  $______________.______
                                                        (rate)
7     Multiply the number of gallons on Line 4c by ________.                                                                              7  $______________.______
                                                        (rate)
8     Multiply the number of gallons on Line 4d by ________.                                                                              8  $______________.______
                                                        (rate)
    9Total prepaid sales tax due during this reporting period (Add Lines 5 through 8.)                                                    9   $______________.______
    10Enter the amount of quarter-monthly payments that you paid on Form PST-3 or by EFT.                                                 10  $______________.______
    11Tax after quarter-monthly payments (Subtract Line 10 from Line 9.)                                                                  11  $______________.______
    12Excess tax collected (See instructions.)                                                                                            12  $______________.______
    13Total tax due (Add Lines 11 and 12.)                                                                                                13  $______________.______
    14Credit amount                                                                                                                       14  $______________.______
    15Payment due (Subtract Line 14 from Line 13.) Make your payment to                     Illinois Department of Revenue.               15  $______________.______
 16   Enter the number of PST-2 forms you have attached.                                                                                  16  ______________________
Step 2: Sign Below
Under penalties of perjury, I state that I have examined this return and, to the best of my knowledge, it is true, correct, and complete.
_________________________________________________________________________/____/_____ 
Taxpayer’s signature                                          Phone                                                                   Date
_________________________________________________________________________/____/_____  
Preparer’s signature                                          Phone                                                                   Date
Mail your completed return and payment to: 
Illinois Department of Revenue, PO Box 19034, Springfield, IL 62794-9034
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 penalty.
PST-1 (R-01/24)          Printed by authority of the State of Illinois, Web only — One copy                                           *303331110*          Page 1 of 1
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