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        Illinois Department of Revenue

        RLG-3            Real Estate Transfer Tax Claim for Credit

Who should fi le this form?
Counties must complete Form RLG-3 to receive credit for returned real estate transfer tax stamps that cannot be used.
How do I fi gure my claim amount?
There are two options available to purchase stamps. Depending on the option used, the county must complete either:
   Line 5: State tax only option —  If you paid only the state tax (purchased at full value and affi xed at the rate of $0.50 per $500 value),        
   write the full value of stamps returned.
   Line 6: State tax and county taxes — If you paid both state tax and county taxes (purchased at 66 2/ 3                             percent (.66666666667) of face  
   value and affi xed at the rate of $0.75 per $500 value), multiply the full value of stamps by .66666666667.

Where do I send my completed Form RLG-3?
Mail your completed Form RLG-3 and attachments to  
                         ILLINOIS DEPARTMENT OF REVENUE
                         PO BOX 19018
                         SPRINGFIELD IL  62794-9018

Step 1: Provide your purchaser information
Illinois Business Tax number (IBT no.): __ __ __ __-__ __ __ __   
County: _______________________________________________   
Address: _______________________________________________   
City:______________________________   ZIP:________________   

Step 2: Check all that apply as to the reason you are completing this claim 
1 _____   Stamps used improperly or issued in excess of required amount  - Attach a copy of the document with the cancelled stamp(s)                                             
        included and clearly showing the amount(s).

2 _____  Damaged stamp - Attach the original stamp. 
3 _____ Stamp meter malfunction - Attach the original stamp. 
4 _____ Other - Describe the situation. Attach additional sheets if needed.
        ________________________________________________________________________________________________________
        ________________________________________________________________________________________________________
        ________________________________________________________________________________________________________
        ________________________________________________________________________________________________________
        ________________________________________________________________________________________________________

Step 3: Figure your claim amount
5 State tax only option  — Write the full value of the stamps returned.                                                               $_________________________
6 State and county taxes option — Multiply the full value of stamps returned by  66 2/ 3% (.66666666667).                             $_________________________ 

Step 4: Sign below - The county offi cial must complete this Step.                                                                                         Offi cial Use
                                                                                                                                       No                           ____________
        I certify that, to the best of my knowledge, the information on this credit claim is true and accurate.                        Amt                          ____________
         _______________________________________________  ___ ___/___ ___/___ ___ ___ ___                                              Apv                          ____________
        Signature of county offi cial                                   Date                                                            Vrf                          ____________
                                                                                                                                       DR                           ____________
                                                                                                                                       Int D                        ____________
        Title: _________________________________________________
                     This form is authorized by the Real Estate Transfer Tax Law in the Property Tax Code (35 ILCS 200/ 31-1 et seq.). Disclosure of information is 
RLG-3 (R-03/09)      REQUIRED. Failure to comply may result in a penalty. This form has been approved by the Forms Management Center. IL-492-1613
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