ILLINOIS DEPARTMENT OF REVENUE 

                    DRAFT FORM 

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Caution: DRAFT—NOT FOR FILING 

This is an early release draft of an Illinois Department of Revenue (IDOR) tax form or instructions, which 
IDOR is providing for substitute forms providers. Do not file draft forms and do not rely on draft forms 
and instructions for filing. We incorporate all significant changes to forms posted with this coversheet. 
However, unexpected issues occasionally arise, or legislation is passed—in this case, we will post a new 
draft of the form to alert users that changes were made to the previously posted draft.  

All forms and instructions have a page on our website at Tax Forms (illinois.gov) where you may see the 
final versions once they are released. Year-end income tax forms are usually released towards the end 
of January. 

If you wish, you can submit comments and questions to IDOR about draft or final forms and instructions 
at REV.VendorForms@illinois.gov. We will forward this information to the Office of Publications 
Management, where forms and publications are administered. 

IDR-1-DIS (N-08/23)          Printed by authority of State of Illinois, web only – one copy. 
 

                                                                                                                    *77712191V*

       Illinois Department of Revenue
                                                                     Certificate of Exemption for 
      
      Form IL-1000-E                                                 Pass-through Withholding
                                 
Read this information first                                                                                         In the event that we notify you that the certificate has been 
                                                                                                                    revoked, the certificate remains valid for 60 days after the 
Owners:                                                                                                             date of notification, and you must then begin withholding for 
Form IL-1000-E should be completed by any owner (partner,
                                                                                                                    income distributable to the owner.
shareholder, or beneficiary) that elects to make its own tax
payments on income from a pass-through entity (partnership,                                                         If the certificate has been revoked, you may not accept 
S corporation, or trust). Individuals may not make the                                                              another certificate from the owner until we notify you.
exemption election.                                                                                                 Specific information for both owners and pass-through
Pass-throughTENTATIVEentities:                                                                                      entities:                         FINAL
In order to accept Form IL-1000-E, make sure that the                                                               Form IL-1000-E must only be completed, signed, and 
certificate is completed and signed by the owner, officer,                                                          submitted once to the pass-through entity. It does not need to 
fiduciary, or authorized representative. Keep the certificates in                                                   be resubmitted on an annual basis. 
your files. Do not send them to us unless we specifically                                                           Do not send Form IL-1000-E to us unless we specifically 
request them from you.                                                                                              request it from you.

Step 1:  Identify the pass-through entity
The pass-through entity must keep this certificate.

                                                                          (                                                   ) 
Name                                                                                                                Phone number
                                                                      
Mailing address                                                                                                     
                                                                                                                   Federal employer identification number (FEIN)
                                                                      
City                      State                    ZIP

Step 2:  Identify the owner (partner, shareholder, or beneficiary)
                                                                      
Name 
                                                                                                                   
                                                                                                                    Federal employer identification number (FEIN)
Mailing address 

                                                                                                                   Check the box to indicate your business type:
City                      State                    ZIP                                                              
                                                                                                                      Corporation
(           )                                                                                                         Subchapter S corporation
Phone number                                                                                                          Partnership
                                                                                                                      Trust
                                                                                                                      Estate

Step 3:  Sign below
I certify that the owner indicated in Step 2 will file all Illinois income tax returns and make timely payment of all Illinois income taxes 
due, and that it is subject to personal jurisdiction of the State of Illinois for purposes of the collection of income taxes due with 
respect to income from the partnership, corporation, or trust indicated in Step 1 of this certificate.

Signature of owner, officer, fiduciary, or authorized representative                                                                          Date

Printed Name                                                                                                                                  Title
                                This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this 
                                information is REQUIRED. Failure to provide information could result in a penalty. 

     IL-1000-E (R-12/19)                                                                                            Printed by the authority of the state of Illinois - electronic only - one copy.