þ Illinois Department of Revenue þ CBS-1 Notice of Sale, Purchase, or Transfer of Business Assets þ þ Complete this form in its entirety. þ þ Type or print clearly. þ þ Read Form CBS-1 Instructions for additional information. Step 1: Identify the business, business assets, or business property being sold or transferred þ 1 þ þ Business name þ 2 þ þ Street address þ þ Street address (if needed) þ þ City þ State þ ZIP þ 3 þ þ Illinois business tax number (IBT no.) or account identi037cation number 4 þ - þ þ Federal employer identi037cation number (FEIN) þ Seq. number 5 þ - - þ Social Security number 6 þ Is the selling entity a disregarded entity? Yes No þ If yes, provide the Illinois Account ID number of the entity þ þ responsible for 037ling with the Illinois Department of Revenue. þ Step 2: Identify the seller or transferor Step 3: Identify the purchaser or transferee Step 4: Describe the terms of sale or transfer þ 7 þ þ þ Name þ 8 þ þ Home or current mailing address þ þ City þ State þ ZIP þ 9 þ þ Daytime phone number þ email address þ 13 þ þ þ Name14 þ þ Current mailing address þ þ City þ State þ ZIP15 þ þ Daytime phone number þ email address16 þ þ Purchaser or transferee222s IBT no. and FEIN10 þ þ Name of seller222s or transferor222s attorney11 þ þ þ Attorney222s mailing address þ þ þ City þ State þ ZIP12 þ þ Attorney222s daytime phone number þ Attorney222s email address17 þ þ þ Name of purchaser222s or transferee222s attorney18 þ þ Attorney222s mailing address þ þ þ þ City þ State þ ZIP19 þ þ Attorney222s daytime phone number þ Attorney222s email address( )( )( )20 þ Date business will be sold þ // þ month þ day þ year21 þ Selling price of the business or the value of the business assets þ þ transferred. $22 þ Was the entire business sold or transferred? (If no, provide a þ þ description of what is being sold.) þ þ Yes þ þ No 23 þ Are the seller222s or transferor222s registration numbers shown on þ þ Line 3 to remain active with IDOR? If no, provide the date to be þ þ discontinued. þ Yes þ No // þ þ month þ day þ yearCBS-1 (R-01/19) front This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is 037led. 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. ( )24 þ Terms of sale or transfer. Put an 223X224 in the appropriate box and þ þ provide additional information as requested. þ þ Cash sale þ þ Contract sale. Complete the following information þ Down payment amount þ $ þ Monthly payment amount þ $ þ Date last payment is due þ // þ þ month þ day þ year þ þ Conventional 037nancing þ þ Other (specify) þ þ Printed by the authority of the State of Illinois. web only, 1 copy American LegalNet, Inc. www.FormsWorkFlow.com Step 5: List any additional persons to whom we must send a copy of the bulk sales correspondence þ If you need to list more than four persons in this step, attach an additional sheet following the same format for each. 25 þ þ Name þ þ Home or mailing address þ þ City þ State þ ZIP þ þ þ Daytime phone number þ Email address þ þ Check one to show association with: þ Seller þ Purchaser26 þ þ Name þ þ Home or mailing address þ þ City þ State þ ZIP þ þ þ Daytime phone number þ Email address þ þ Check one to show association with: þ Seller Purchaser27 þ þ Name þ þ Home or mailing address þ þ City þ State þ ZIP þ þ þ Daytime phone number þ Email address þ þ Check one to show association with: þ Seller þ Purchaser28 þ þ Name þ þ Home or mailing address þ þ City þ State þ ZIP þ þ þ Daytime phone number þ Email address þ þ Check one to show association with: þ Seller þ Purchaser þ 29 þ þ Your name30 þ þ þ þ Your mailing address þ þ City þ State þ ZIP31 þ þ Daytime phone number þ Email address( )( )( )( )Step 6: Identify yourself (the person submitting the form) Step 7: Submit completed formAttach a copy of the 037nancing agreement (if requested), and a copy of the following from the sales contract to Form CBS-1: þ Page(s) identifying the business, assets, and/or property being sold þ Page(s) identifying the purchase price þ Page(s) identifying how payment is to be made þ Signatures of the purchaser or transferor and seller or transfererSubmit Form CBS-1 by þ completing the form on our website and clicking the 223Submit224 button at the bottom of the page* þ emailing the form to REV.bulksales@illinois.gov þ faxing the form to þ 217 785-2635 þ mailing the form to þ BULK SALES UNIT þ ILLINOIS DEPARTMENT OF REVENUE þ P.O. BOX 19035 þ SPRINGFIELD IL 62794-9035CBS-1 (R-01/19) back * þ If you have an email address linked to your web browser, you should submit Form CBS-1 by using the 223Submit224 button at the bottom of the form on our website. If you do not have an email account linked to your web browser, save the form and send it as an email attachment.( ) American LegalNet, Inc. www.FormsWorkFlow.com