
Illinois Department of Revenue
CBS-1 Notice of Sale, Purchase, or Transfer of Business Assets
General information
You (or the purchaser or the transferee) must complete Form CBS-1
if, outside your usual course of business, you sell or transfer the
major part of the
• stock of goods that you are in the business of selling,
• furniture or fixtures,
• machinery and equipment, or
• real property of your business.
Forms received more than 10 days after the sale date will not be pro-
cessed. The purchaser or transferee may be held liable for any debt
incurred by the seller.
Part 1: Identify the business being sold or transferred and the identification numbers
1 ____________________________________________________ 3
_______________________________________
Business name Illinois business tax number (IBT no.) or account identification number
2 ____________________________________________________ 4
___ ___-___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Street address Federal employer identification number (FEIN) Seq. number
____________________________________________________ 5
___ ___ ___-___ ___-___ ___ ___ ___
Street address (if needed) Social Security number
____________________________________________________
6 Are you required to pay any excise taxes
?
Yes
No
City State ZIP
Excise tax number
________________________________________
Part 2: Identify the seller or transferor
7 ____________________________________________________ 9 __________________________
Name Daytime phone number
8 ____________________________________________________ 10 ____________________________________________________
Home or mailing address Name of seller’s or transferor’s attorney Daytime phone number
____________________________________________________ 11 ____________________________________________________
City State ZIP Address of attorney
Part 3: Identify the purchaser or transferee
12 ____________________________________________________ 14 ____________________________________________________
Name Purchaser’s or transferree’s IBT no. and FEIN
13 ____________________________________________________ 15 ____________________________________________________
Home or mailing address Name of purchaser’s or transferee’s attorney Daytime phone number
____________________________________________________ 16 ____________________________________________________
City State ZIP Address of attorney
Part 4: Describe the terms of sale or transfer
17
Date business was or will be sold or transferred.
___/___/____
21 Terms of sale or transfer. Write “X” in the appropriate box, and
Month Day Year
provide additional information as requested.
18 Selling price of the business or the value of the business Cash sale
assets transferred: $ ____________________ Contract sale. Complete the following information:
19 Was the entire business sold or transferred? • Down payment amount: $ ____________________
Yes • Monthly payment amount: $ ____________________
No - You must complete Line 20. • Date last payment is due
___/___/____
20 Are the seller’s or transferee’s registration numbers with the
Month Day Year
department to remain active? Conventional financing
Yes Other (Specify.): ____________________________________
No - Write the date to be discontinued.
___/___/____
_________________________________________________
Month Day Year
_________________________________________________
Part 5: Sign below. This must be completed by the person submitting this Form.
22 ____________________________________________________ 24 ____________________________________________________
Print or type your name Daytime phone number
Signature Date
23 ____________________________________________________
Mailing address of person
This form is authorized as outlined by the Illinois Income Tax Act [35 ILCS 5/902] and the Retailers’ Occupation Tax Act [35 ILCS 120/5j]. You are required to report all sales
of businesses to the Illinois Department of Revenue. Disclosure of this information is REQUIRED. Failure to provide such information may result in the purchaser or transferee
becoming personally liable for the amount of tax owed by the seller. This form has been approved by the Forms Management Center. IL-492-4224
CBS-1 (R-4-09)
If you need additional information, you may call our Chicago office
weekdays between 8:30 a.m. and 5:00 p.m. at 312 814-3063.
Mail your completed Form CBS-1, a copy of the sales contract, and
financing agreement to:
BULK SALES UNIT
ILLINOIS DEPARTMENT OF REVENUE
100 WEST RANDOLPH LEVEL 7-400
CHICAGO IL 60601
You may fax your form and sales contract to us at 312 793-3841.
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