Self Storage Monthly Form

Business Name*

DBA*

Reporting Period: (Month/Year)*

FEIN*

Tax form and return payment is due by the 15th of each month to avoid penalties.

Payments can be mailed to the Village of Tinley Park at 16250 Oak Park Ave, Tinley Park, IL 60477 or can be accepted at the Village of Tinley Park Village Hall during normal business hours. Include a copy of the Illinois Department of Revenue Sales & Use Tax Return (ST-1) with your tax return.

1. Gross Receipts during reporting period:*

2. Amount of Tax (Multiple Line 1 by 5% (.05))

3. Total Payment Due:

Under penalties as provided by Tinley Park Ordinance 2020-O-014, I declare that to the best of my knowledge and belief the information on this form is true, correct, and complete.

Signature*

Date*

Date

Printed Name & Title*

Phone Number*

Format: (000) 000-0000.