This application is
    Illinois	Department	of	Revenue                                                                                                                                                                  New     Revised 
	   IL-8633-I		Application	to	File	Illinois	Individual	Income	Tax	Returns	Electronically
                                   for	Software	Developers
	   Mail	to:  Electronic Commerce Division, Illinois Department of Revenue, P.O. Box 19479, Springfield, IL  62794-9479

An assigned Internal Revenue Service (IRS) Electronic Filer Identification number (EFIN) and an IRS Electronic Transmitter 
Identification number (ETIN) are required to complete Form IL-8633-I.  We will not process Form IL-8633-I without both the 
IRS identification numbers. If any of the information you provide below changes after you submit your Form IL-8633-I, you must 
complete and submit a "Revised" Form IL-8633-I to update your information. 

Step	1:		Complete	the	following	information
	
1   _________________________________________________                                                6  __________________________________________________
    Legal name of business (as shown on tax return)                                                    Federal employer identification number (FEIN) or Social Security number (SSN)

2   _________________________________________________                                                7  __________________________________________________	                                                            
    Doing business as (dba) name (if different than Line 1)                                            Primary contact representative

3   _________________________________________________                                                  __________________________________________________Ext.:
    Business street address                                                                            Daytime phone - include area code             FAX number and area code

    _________________________________________________                                                8  __________________________________________________                                                             
    City                                                            State                       ZIP    Alternate contact representative  

4   _________________________________________________                                                  __________________________________________________Ext.:
    Mailing address (if different than above)                                                          Daytime phone - include area code             FAX number and area code

	   _________________________________________________                                                 
    City                                                            State                       ZIP   

5   _________________________________________________
    Business e-mail address 

Step	2:		Provide	your	EFIN	and	ETIN		

	9	 EFIN: ___ ___ ___ ___ ___ ___                                ETIN: ___ ___ ___ ___ ___  

Step	3:		Sign	below	-	Signature	is	required	for	both	new	and	revised	applications
Under the penalties of perjury, I state that I have examined this form and, to the best of my knowledge it is true, correct, and complete. 
I state that this business will comply with all the provisions of the program, that acceptance for participation is not transferable, and that 
noncompliance will void participation in the program. I am authorized to make and sign this statement on behalf of the business.
     ___________________________________________________                                                ____________________________________________________
    Name and title of official or principal owner of the business (Please print.)                       SSN of an official or principal owner of the business
     ___________________________________________________                                                ____________________________________________________ 
    Signature of the official or principal owner of the business                                        Date

                                   This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this information is required of those taxpayers to whom this form applies.    
IL-8633-I (R-12/12)                Failure to provide this information when required could result in a penalty. This form has been approved by the Forms Management Center.  IL-492-2742
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                                    IL-8633-I	Instructions

                                    General	Information

Who	must	submit	this	application?
Any business that devleops electronic return formatting software must submit Form IL-8633-I, Application to File Illinois 
Individual Income Tax Returns Electronically for Software Developers, to participate in the Illinois Individual Income Tax 
Electronic Filing Program. If any of the information you provide changes after you submit your Form IL-8633-I, you must 
complete and submit a "Revised" Form IL-8633-I, to update your information. This includes any business that is sold or changes 
its organizational structure. 	

CAUTION:	Electronic Return Originators (EROs), DO	NOT submit Form IL-8633-I, or send a copy of the IRS 8633, or the IRS 
acceptance letter. EROs that are registered in the IRS Electronic Filing Program, and are in good standing, are automatically 
registered in the Illinois program. 

Where	should	I	mail	the	application?
                   ELECTRONIC COMMERCE DIVISION
                   ILLINOIS DEPARTMENT OF REVENUE 
                   PO BOX 19479
                   SPRINGFIELD IL  62794-9479

What	if	I	have	questions?
If you have questions, write us at Electronic Commerce Division, Illinois Department of Revenue, PO Box 19479, Springfield, 
Illinois 62794-9479; or call our Springfield office weekdays between 8 a.m. and 4 p.m. at 217	524-4767. You can also visit our 
Web site, which features electronic filing information, forms, and booklets at tax.illinois.gov.

                                    Step-by-Step	Instructions

Step	1:		Complete	the	following	information                      Step	2:	Provide	your	EFIN	and	ETIN

Line	1	-	Write the legal name of your business (as shown on      Line	9	-	Write your EFIN and ETIN. You must have a valid 
your tax return).                                                EFIN and ETIN that has been assigned and approved by the 
                                                                 IRS.
Line	2	-	If, for the purpose of electronic filing, your business 
uses any name other than the name on Line 1, write that 
                                                                 Step	3:		Sign	below
name.
                                                                 Signature	is	required	for	both	new	and	revised	
Line	3	through	5	-	Follow the instructions on the form.          applications.
                                                                 Read the applicant’s agreement and provide the name, title, 
Line	6	-	If you are a partnership or corporation, write your     and SSN of the person who is authorized to act and sign for 
federal employer identification number (FEIN). Sole proprietors  your business in legal or tax matters. Also, sign and date the 
without a FEIN, write your Social Security number (SSN).         application. All applications must have an original signature 
                                                                 and date. We will not accept a photocopy of a signature.
Lines	7	and	8	-	Provide the name, daytime phone and FAX 
(including area code) of your primary and alternate contact 
representatives. Note: It may be necessary to contact your 
business during testing and throughout the processing year.

IL-8633-I (R-10/10)