IL-1065-X-V instructions 

Prepare each IL-1065-X-V form with the following information:                                
        (1)   Software/Forms Developer ID Number
        (2)  Federal Employer Identification Number (FEIN)
        (3)  Sequence Number (usually 000)
        (4)  FEIN/Sequence Number Check Digit (See FEIN/Sequence Number Check Digit Formula section.)
        (5)  Tax Year Ending Month (last month of the business year - use two digits)
        (6)  Tax Year Ending (last two digits of the business year)
        (7)  Business Name and Address
        (8)  Amount of Payment. The payment amount field must show dollars and two positions for cents.                   
             (Whole dollars only)    
        (9)  Preparer’s Phone Number
        (10) Scan Line (See Scan Line Placement and Contents section.)
        (11) 1-D Bar Code (See 1-D Barcode section.)

(4) FEIN/Sequence Number Check Digit Formula
The check digit is figured from the following calculations.
Step 1: Beginning at the left most digit, multiply each digit of the FEIN alternating by 2 and then 1. 
     EXAMPLE: FEIN Sequence Number = 3 6 2 6 0 3 5 9 8 0 0 0  
             3       6      2       6        0       3       5      9           8     0          0     0 
        X    2       1      2       1        2       1       2      1           2     1          2     1
          =  6       6      4       6        0       3    10        9   16            0          0     0
Step 2: Add any two-digit number in the products together to obtain one digit.  (10 = 1 + 0 = 1) (16 = 1 + 6 = 7) 
Step 3: Add the Step 1 products together substituting the one-digit number found in Step 2 for the two-digit number. 
     6 + 6 + 4 + 6 + 0 + 3 +  1+ 9 +  7+ 0 + 0 + 0 = 42. 
Step 4: Determine the unit (ones) position of the result of Step 3. The unit position of 42 is 2.
Step 5: If the result of Step 4 is zero, zero is the check digit. If the result of Step 4 is not zero, subtract the unit 
     position from 10.  In this example, 2 is the result of Step 4. 10 - 2 = 8. 8 is the check digit.

(10) Scan Line Placement and Contents 
The scan line must be centered horizontally on the page (the center of the scan line must be at 4.25 inches) and 
must fall between .25 and .375 inches from the bottom edge of the form. There must be only the scan line in the 
bottom .5 inch of the form. 
Contents: The scan line contains 39 positions as described below. The font for the scan line is “OCR-A Std”, size 10.
   Positions within the scan line:
     1 - 5  Voucher Number is always 10659
     6 - 9  Liability Period (mmyy) (Last month and last two digits of the business accounting period)
          Example: December 2023 is 1223.
     10  Space 
     11   Form Code/Liability Period Check Digit (See formula on the following page.)
     12  Space 
  13 - 21  FEIN 
     22  Space
  23 - 25  Sequence Number (000)
     26   Space
     27  FEIN/Sequence Number Check Digit (See formula on this page.)
     28   Space
  29 - 39   Amount 

                                           IL-1065-X-V instructions (continued)

     Form Code/Liability Period Check Digit Formula
     The check digit is figured from the following calculations.
     EXAMPLE: Form code/Liability Period = 1 0 6 5 9 1 2 2 3
     Step 1:    Beginning at the left most digit, multiply the left most digit by 10, the next digit by 9, the next by 8 and so    
                           on, until all digits have a total.
                              1              0   6          5       9  1            2  2   3
                              X  10          9   8          7       6  5            4  3   2
                           =   10            0   48         35     54  5            8  6   6
     Step 2:     Add the products together. 10 + 0 + 48 + 35 + 54 + 5 + 8 + 6 + 6 = 172
     Step 3:     Divide the sum by 11. Determine the remainder. 172 divided by 11 = 15 with a remainder of 7.
     Step 4:     If the remainder is 0 or 1, the remainder is the check digit. If the remainder is greater than 1, subtract the   
                           remainder from 11 to obtain the check digit. 11 - 7 = 4. 4 is the check digit.

     (11) 1-D Barcode
     1-D Barcode font is “Free 3 of 9 Extended”, size 30 pt (height around 5/16 inch). Leave at least 1/4 inch quiet zone 
     (white space) around the barcode. Reproduce the exact barcode shown on the voucher. The content of the barcode 
     is: *64312231V*

     Important: Electronic payments are required if the taxpayer’s previous year’s annual liability was $20,000 or 
     more.

     Below is an example of the payment voucher with the required preprinted fields. 
     (Do not reproduce the red numbered notes; they are provided for reference.)
     Email five drafts for testing and review to REV.VendorForms@Illinois.gov.

     Printed by the authority of the state of Illinois - electronic only - one copy.

             Illinois Department of Revenue
                                                                   Payment Voucher for Amended 
             IL-1065-X-V                                    (1)     Partnership Replacement Tax                        Official use only
                       IL-1065-X-V (R-12/23)     ID: 123                                  
                              Mail to: Illinois Department of Revenue, P.O. Box 19016, Springfield, IL  62794-9016
               If no payment is due or you make your payment electronically, do not file this form.
                                                                                                                Tax year ending
                                                                                                                   (5)           (6)
                                                                                                         1    2            2    3
      FEIN               (2)  36-2603598      (3)000      (4)         8
                                                                                                             Month     Year
                                                    (7)
      Business                                                                                               (8)
                                                                                              $                    500           00
      1234 Market St
                                                                                                Amount of payment (Whole dollars only)
      Anywhere IL  12345-1234                                                         Write your FEIN, tax year ending, and “IL-1065-X-V” on your check or 
                                                                                                
                                                                                      money order and make it payable to “Illinois Department of Revenue.”
                                                                                           
                                                                (9)
      Preparer’s phone number                (555)123-1234
                                                                                                    (11) *64312231V*
                                             (10)
                                             106591223 4 362603598 000 8 00000050000