Places for Eating Tax Registration

Every business that sells prepared food at retail in Hampshire is required to pay a one percent (1%) tax on the gross receipts received for such. Registration for the Places for Eating Tax is required. If you believe you are not required to pay this tax, please indicate such on the form below.

All fields are required unless otherwise noted.

Business Name:

Legal Name:

if different than Business Name

Business Location Address:

Business Mailing Address:

if different from location address

Business Phone:

( ) -

Business Email:

if none, but N/A

Date Business Commenced:

Today

Select One:

Owner's Name:

Owner's Home Address:

Owner's Phone:

( ) -

Owner's Email:

Emergency Contact:

Emergency Contact's Number:

( ) -

IL Sales Tax #:

Federal Tax ID #:

Current frequency of filing IL Sales Tax Return:

Consent and Signature:

Under penalties as provided by law, I declare that to the best of my knowledge and belief, the information on this form is true, correct and complete. I also understand that my information may be used for other Village purposes and give consent to the same.

After successful submission, you will see a thank you message.