Name: FEIN: andout Sample

1 Illinois Department of Revenue [transaction return #]. RUT-25-LSE. (N-01/15). Use Tax Return for Lease Transactions Station 403. (For use with leased vehicles, watercraft, aircraft, trailers, and mobile homes. REV 01 FORM 963. Not for use with non-leased items. Instead, use Form RUT-25.) RC CA. Do not write above this line. Step 1: Enter the leasing company's information 1 Name: 3 FEIN: - Handout Sample 2 Address: 4 Mailing address: (if different) Step 2: Enter the lessee's information - Enter the name and address as they appear on the registration application 1 Name: 5 Lessee's city, village, or town, if different from Line 3: Not for Distribution 2 Co-lessee: 3 Street address: 6 County (required): (Do not use PO box). City: 7 Township (see instr.)

2 : (Do not abbreviate). State, ZIP: 8 Daytime phone: (Illinois address only). 4 Is address outside the city limits? Yes No 9 FEIN or SSN: Step 3: Describe the item being leased 1 Year: 5 Purchase date: M M D D Y Y Y Y. 2 Make: 6 Date brought into Illinois: M M D D Y Y Y Y. 3 Model: 4 Identification number (VIN, HIN, N): Step 4: Mark the box that best describes your transaction if exempt from tax Skip to Step 5 if your transaction is taxable. a Lease to tax-exempt governmental body - Provide exemption number: E a b Lease for use as farm implement or lease of ready-mix concrete truck b c Lease to interstate carrier for use as rolling stock - Provide certificate of authority number: c Step 5: Indicate how you determined your purchase price - Check the box that indicates the amount entered in Step 6, Line 1.

3 The purchase price in Step 6 is: a the amount due at signing, plus the total amount of lease payments (see rules of eligibility in instructions), or b the actual purchase price. Step 6: Figure tax - Attach a copy of your lease agreement. Round to nearest dollar 1 Purchase price (If eligible, this is the amount due at signing, plus total lease payments. Otherwise enter the actual purchase price.) 1 _____. 2 Total trade-in credit or value - Do not enter any amount on Line 2 if you checked Box a in Step 5 above. 2 _____. *596311110*. 3 Net taxable amount prior to depreciation. Subtract Line 2 from Line 1. 3 _____. 4 Depreciation for out-of-state use 4 _____. 5 Taxable amount. Subtract Line 4 from Line 3. 5 _____. 6 Multiply Line 5 by the tax rate.

4 Enter the tax rate: _____ 6 _____. 7 Credit for tax previously paid to another state or to a retailer. Identify: 7 _____. 8 Tax due. Subtract Line 7 from Line 6. This is your total amount due. 8 _____. Step 7: Sign here 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. _____ _____. Your signature Date Co-owner's signature Date Do not write below this line. This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is required. Failure to provide information may result in this form not being processed and may result in a penalty. Date received by Illinois state government