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  02
                                                                                                                                Form  019
         ST-44 Illinois Use Tax Return                                                                                          RC  NS  DP  CA  E  S  __/__/__

Step 1:  Identify yourself
Your name                                                        Daytime phone number 

Number and street                                                Social Security number 
                                                                 or
City, State, ZIP                                                 FEIN

Step 2:  Figure the Illinois Use Tax - Round figures to whole dollars.
     Enter the date of your last purchase 
     If you are filing an annual return, enter “December 31,” followed by the year.
     If you are not filing an annual return, enter the full date of your last purchase.

 1a  Enter the total cost of general merchandise   
     you purchased outside of Illinois to use in Illinois.                                             1a 

 1b  Multiply Line 1a by 6.25% (.0625).                                                                1b  

 2a  Enter the total cost of qualifying food, drugs, medical appliances, 
     and diabetic supplies, such as insulin and syringes, you purchased
     outside of Illinois to use in Illinois.                                                           2a 

 2b  Multiply Line 2a by 1% (.01).                                                                     2b  

    3Add Lines 1b and 2b. This is your use tax on purchases.                                           3 

    4Enter the amount of sales tax you paid to another state (not to another country) 
     on the items included on Lines 1a and 2a.                                                         4 

Step 3:  Figure the total amount you owe
    5Compare Line 3 and Line 4. If Line 4 is equal to or greater than Line 3, you do not 
     owe use tax. If Line 3 is greater than Line 4, subtract Line 4 from Line 3.  
     This is the total amount you owe.                                                                 5 

     Make your payment to the “Illinois Department of Revenue.”

Step 4:  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. 

Your signature                                                                                    Date 
     Send your return and payment to:        ILLINOIS DEPARTMENT OF REVENUE
                                             RETAILERS’ OCCUPATION TAX
                                             SPRINGFIELD, IL  62776-0001
     Do not attach your payment or this form to any other tax return.

                                                                                                                                      *801921110*

                                                           Reset             Print

                          This form is authorized as outlined by the Use Tax Act. Disclosure of this information is required. Failure 
                               to provide information may result in this form not being processed and may result in a penalty.  
                                                   Printed by authority of the State of Illinois -
ST-44 (R-05/23)                                            Web only, One copy