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         Illinois Department of Revenue
 
         ST-4   Metropolitan Pier and Exposition Authority
                          Food and Beverage Tax Return
                                                                                                                                                     REV   02     FORM   028
  Account ID: ______________________  This form is for: __________________________________                                                           E    S     ____/____/____
  Reporting Period (month day year - month day year)                                                                                                 NS      DP      CA      RC
Owner’s name:   _________________________________________________________________________                                                               Do not write above this line.
Business name:    _________________________________________________________________________
Mailing address:   _________________________________________________________________________
                       _________________________________________________________________________
You must round your fi gures to whole dollars. See instructions.     
Step 1:  Figure your taxable receipts
 1  Total receipts -  Write the total amount you received from qualifying sales of food, alcoholic beverages, 
      and soft drinks, including MPEA tax you collected. Do not include any other tax you collected.                                               1 __________________

   Deductions2
        a  Write taxes included in Line 1.    __________________2a

        b  Write tax-exempt sales included in Line 1.  2b __________________

        Add Line 2a and Line 2b.    2 __________________

    3Taxable MPEA receipts (Subtract Line 2 from Line 1.)                                                                                          3 __________________

Step 2:  Figure your net tax and discount
    4MPEA tax due on receipts (Multiply Line 3 by 1% (.01).)                                                                                       4 __________________

   5If you fi led and paid by the due date, multiply Line 4 by 1.75% (.0175).                                                                       5 __________________

    6Net MPEA tax due (Subtract Line 5 from Line 4.)                                                                                               6 __________________

    7Excess MPEA tax collected                                                                                                                     7 __________________

    8Total tax (Add Line 6 and Line 7.)                                                                                                            8 __________________

Step    3:  Figure your payment due 
    9Credit amount                                                                                                                                 9 __________________

10    Payment due (Subtract Line 9 from Line 8.)                                                                                                   10 __________________
       Make your check payable to “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. 

______________________________________________________________________________
Taxpayer’s signature                                                      Phone                       Date

______________________________________________________________________________
Preparer’s signature                                                      Phone                       Date

Mail your completed return and payment to: 
Illinois Department of Revenue, Retailers’ Occupation Tax, Springfi eld, IL  62776-0001
                                This form is authorized by the Metropolitan Pier and Exposition Authority Act. Disclosure of this information is REQUIRED.  Failure to 
                                provide it could result in a penalty. This form has been approved by the Forms Management Center.       IL 492-3203

                 ST-4  (R-11/09)

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