VILLAGE OF MORTON GROVE
MOTOR FUEL SALES TAX

Monthly Remittance Form BKN.MFT.2015
Revised 09/01/2015

Finance Department
Village of Morton Grove
6101 Capulina Avenue
Morton Grove, IL 60053


Business Information

9.  Under penalties of perjury and other penalties provided by law, I declare that I have examined this return and to the best of my knowledge and belief it is true, correct and complete. I further declare that the information set forth is taken from the books and records of the business for which this return is filed.



10.  Signature of Taxpayer

15. COMPUTATION OF MOTOR FUEL SALES TAX LIABILITY
  
$

18.  Late Penalties (penalties will apply after the due date of the return and the payments)

$
$
Number of Months:    Interest Penalty: $
$
$

24.  Mail this completed return and a check or money order for the amount shown on line 23. You must include a copy of the Illinois Department of Revenue for ST-1 and Schedule A-Deductions for the period indicated on Line 1