Home Rule Tax Complaint Report: Use this form to submit complaints or reports of potential tax evasion, fraud, or abuse to the Cook County Department of Revenue. (NOTE: any items marked with an asterisk * are required fields and must be completed before submitting.)
Please select the home rule tax/item about which you are wishing to report.
Provide the name of the business or organization for the incident you are reporting.
What type of business is this? (e.g. grocery store, gas station, restaurant, convenience store, etc.)
If available, please provide the business address or location of the incident.
Provide the city of this business or location.
The state of the business or location being reported.
Zip code of the business or location being reported.
Describe the incident or circumstances where you believe a violation occurred. For tobacco or cigarette tax violations, please provide information about the sale (if the pack was unstamped, loose cigarette sales, counterfeit cigarettes, or counterfeit stamps). For sweetened beverage tax violations, please provide description of beverage (brand, name, size, quantity) and what type of violation (improperly charged, taxed for non-taxable items, or not charged a tax).
Provide the date that the transaction or incident occurred.
Provide the approximate time of the transaction or incident.
Provide your name, in case we need to contact you for additional information about this report.
Provide the phone number where you can be reached for additional information about this report. (Optional, but if we cannot reach you, we may not be able to gather sufficient information for this investigation)
Use this upload function to attach supporting documentation for this complaint, such as a photo of a receipt, or missing stamp, etc. Please try to include relevant information to your report in the file. NOTE: To include a file upload in your submission, click Choose File and select the file you wish to upload, once selected you must click Upload to upload the file to the form before you submit your report.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
An additional file upload option if needed for your submission.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
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