New Submission

PaymentResponsefield type single line
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File Date*field type date
Owner / Corporate Name*field type single line
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Addressfield type single line
Number, Street, City, State, Zip
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Contact Namefield type single line
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Contact Phonefield type single line
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Contact Email*field type email
Business Information
(if different from above)
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- Business Namefield type single line
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- Addressfield type single line
  Number, Street, City, State, Zip
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- Contact Namefield type single line
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- Contact Phonefield type single line
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- Contact Emailfield type email
Add another location in McHenry

Tax Calculation

	Collection Month*field type drop-down	Year*field type drop-down
row 1	Collection Month*field type drop-down	Year*field type drop-down

Do you report multiple locations on a filed ST-1, ST-2, or CMFT-2 Form?*field type radio button
Do you report multiple locations on a filed ST-1, ST-2, or CMFT-2 Form?NoYes
ST-1, ST-2, or CMFT-2 Account ID*field type single line
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Final Return?field type drop-down

	Total Gallonsfield type number
Gasoline (Line 18 ST-1)	Total Gallonsfield type number
Gasohol and majority blended ethanol (Line 19 ST-1)	Total Gallonsfield type number
Diesel (including biodiesel and biodiesel blends) (Line 20 ST-1)	Total Gallonsfield type number
Dieselhol and other fuels at diesel rate (Line 21 ST-1)	Total Gallonsfield type number
Liquefied natural gas and liquefied petroleum gas (Line 22 ST-1)	Total Gallonsfield type number
Compressed natural gas and other fuels at gasoline rate (Line 23 ST-1)	Total Gallonsfield type number
Fleet Card Sales	Total Gallonsfield type number
Sales from ST-2 or CMFT-2	Total Gallonsfield type number
Other Sales Not Reported on ST-1, ST-2, or CMFT-2	Total Gallonsfield type number

Payment Option*field type radio button
Payment OptionACH PaymentCheckPay Online with Credit Card
City Treasurer Carolyn Lynch will email you the ACH information needed for the transaction.
ST-1, ST-2, or CMFT-2 Uploadfield type file upload
Upload Sales and Use Tax and E911 Surcharge Return
Drop files here
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Signature*field type signature

Payment Amount*field type currency
$
Name on Credit Card*field type single line
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CVV*(?)field type single line
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Billing Zip Code*(?)field type single line
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Tokenfield type single line
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