Illinois Certificate of Exemption for Pass-through Withholding Payments

Certificate of Exemption for Pass-through Withholding Payments
Form IL-1000-E, Certificate of Exemption for Pass-through Withholding Payments
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	Illinois Department of Revenue

	Form IL-1000-E	
	

*77712191W*

Certificate of Exemption for
Pass-through	Withholding

Read this information first

In the event that we notify you that the certificate has been
revoked, the certificate remains valid for 60 days after the
date of notification, and you must then begin withholding for
income distributable to the owner.

Owners:
Form IL-1000-E should be completed by any owner (partner,
shareholder, or beneficiary) that elects to make its own tax
payments on income from a pass-through entity (partnership,
S corporation, or trust). Individuals may not make the
exemption election.

If the certificate has been revoked, you may not accept
another certificate from the owner until we notify you.
Specific information for both owners and pass-through
entities:
Form IL-1000-E must only be completed, signed, and
submitted once to the pass-through entity. It does not need to
be resubmitted on an annual basis.
Do not send Form IL-1000-E to us unless we specifically
request it from you.

Pass-through entities:
In order to accept Form IL-1000-E, make sure that the
certificate is completed and signed by the owner, officer,
fiduciary, or authorized representative. Keep the certificates in
your files. Do not send them to us unless we specifically
request them from you.

Step 1:	 Identify the pass-through entity
The pass-through entity must keep this certificate.

	 (

)	

Name			
Phone number

	

Mailing address	

		
City	

State	

	

ZIP

Federal employer identification number (FEIN)

Step 2:	 Identify the owner (partner, shareholder, or beneficiary)
	

Name	

	 Federal employer identification number (FEIN)

Mailing address	

	

Check the box to indicate your business type:
	
	
			
	Corporation
(
)
	 Subchapter S corporation
	
Phone number				
	Partnership
			
	Trust
	
				
	 Estate
City	

State	

ZIP	

Step 3:	 Sign below
I certify that the owner indicated in Step 2 will file all Illinois income tax returns and make timely payment of all Illinois income taxes
due, and that it is subject to personal jurisdiction of the State of Illinois for purposes of the collection of income taxes due with
respect to income from the partnership, corporation, or trust indicated in Step 1 of this certificate.
	

Signature of owner, officer, fiduciary, or authorized representative		

	

Printed Name				

Date

	

	

Title

This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this
information is REQUIRED. Failure to provide information could result in a penalty.

IL-1000-E (R-12/19)

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Printed by the authority of the state of Illinois - electronic only - one copy.