Form EG-13-I – Fill Out and Use This PDF

The Illinois Department of Revenue EG-13-I form serves as a comprehensive statement for individuals to report their financial status and other pertinent information to the state. It is a crucial document that assists in detailing one's financial situation, including assets, liabilities, income, and expense analysis, while also covering employment details, property descriptions, and any pending bankruptcy proceedings. Interested parties are encouraged to accurately complete and submit this form to ensure compliance and avoid potential processing delays. Click the button below to fill out your form.

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Form EG-13-I PDF Details

The Illinois Department of Revenue EG-13-I, formally known as the Financial and Other Information Statement for Individuals, serves as a comprehensive document designed to collect detailed financial information from individuals. This form, integral to state financial processes, requires individuals to disclose not only basic personal and employment information but also extends into detailed financial territories including assets, liabilities, and monthly income and expenditure. The form is structured in a way that guides the filer through several steps, starting with personal identification and employment details, moving through income and property disclosure, and ending with a declaration of any pending bankruptcy or similar financial distress situations. Further, it necessitates a full disclosure of assets and liabilities, capturing information on bank accounts, household furniture, mortgages, and more, culminating in a monthly income and expense analysis to encapsulate the debtor’s financial health comprehensively. It underscores the significance of accuracy and honesty, as submissions are under the penalty of perjury. Designed to aid in the resolution of tax or financial discrepancies, the EG-13-I highlights the Illinois Income Tax Act's requirements and underscores the consequences of failure to provide the necessary information, including the potential for non-processing of the form.

Question	Answer
Form Name	Form EG-13-I
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	eg 13, form eg 13 i, eg 13 i form illinois, eg 13 1 forms, financial and other information statement for individuals

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Illinois Department of Revenue

EG-13-I Financial and Other Information Statement for Individuals

Note: We may require support for amounts shown on this form.

Step 1: Tell us about yourself and your employment

Debtor’s information				Employment information
1	Your name ___________________________________________			7	Employer’s name _____________________________________
	Street address ________________________________________				Address ____________________________________________
	____________________________________________________				____________________________________________________
	City	State	ZIP		City	State	ZIP
2	Email address ________________________________________			8	Work phone (_____)________________
3	Home phone	(_____)________________		9	Length of employment _________________________________
4	Date of birth	___ ___/___ ___/___ ___ ___ ___

5 Social Security number ___ ___ ___ - ___ ___ - ___ ___ ___ ___

6Number of dependents in household _______________________

Step 2: Tell us about other income and property. Attach an additional sheet, if necessary.

10Real property (brief description and location) _________________________________________________________________________

_____________________________________________________________________________________________________________

11 List the name and address of the banks where you have accounts.
Name_______________________________________________			Name_______________________________________________
Address _____________________________________________			Address _____________________________________________
____________________________________________________			____________________________________________________
City	State	ZIP	City	State	ZIP
Name_______________________________________________			Name_______________________________________________
Address _____________________________________________			Address _____________________________________________
____________________________________________________			____________________________________________________
City	State	ZIP	City	State	ZIP

12Vehicle license number_____________________________________________________________________________________________________

Vehicle description _____________________________________________________________________________________________

Step 3: Tell us if bankruptcy is pending

13Are foreclosure, bankruptcy, receivership, or assignment for beneﬁt of creditors proceedings pending? ____yes ____no

14Bankruptcy number ____________________________________

15Date ﬁled ___ ___/___ ____/___ ___ ___ ___

Continue to next page.

EG-13-I front (R-5/12)

Step 4: Complete the following statement of assets and liabilities

		A	B	C	D	E	F	G
				Amount of	Monthly		Date of	Date of
		Present	Liabilities	equity or asset	payment		ﬁrst	ﬁnal
Description		value	Balance due	(Col. A minus B)	amount	Pledgee or obligee	payment	payment
16	Bank accounts	_________	_________	_________	_________	__________________	________	________
17	Household furniture	_________	_________	_________	_________	__________________	________	________
18	Home mortgage	_________	_________	_________	_________	__________________	________	________
19	Rental properties	_________	_________	_________	_________	__________________	________	________
20	Real property	_________	_________	_________	_________	__________________	________	________

21Vehicles (model/year)

a__________________ _________ _________ _________ _________ __________________ ________ ________

b__________________ _________ _________ _________ _________

__________________

________

22Other assets (describe)

a__________________ _________ _________ _________ _________ __________________ ________ ________

	b__________________	_________	_________	_________	_________	__________________	________	________
23	Federal taxes outstanding	_________	_________	_________	_________	__________________	________	________
24	State taxes outstanding	_________	_________	_________	_________	__________________	________	________
25	Accounts/notes payable	_________	_________	_________	_________	__________________	________	________

26Charge cards

a__________________ _________ _________ _________ _________ __________________ ________ ________

b__________________ _________ _________ _________ _________

__________________

________

27Other (include judgments)

a__________________ _________ _________ _________ _________ __________________ ________ ________

b__________________	_________	_________	_________	_________	__________________	________	________
28 Total	_________	_________	_________	_________

Step 5: Complete the following monthly income and expense analysis

	Household monthly income			Monthly expenses
	Source	Net		Expense	Amount
29	Your take home pay	___________________	35	Rent (if no home mortgage in Step 4) ___________________
30	Your spouse’s take home pay	___________________	36	Groceries	___________________
31	Pensions	___________________	37	Monthly payments (from Line 28)	___________________
32	Rental income	___________________	38	Utilities	___________________
33	Other (specify)		39	Auto expenses (I.E., insurance, gas)	___________________
	________________	___________________	40	Child support paid	___________________
	________________	___________________	41	Other (specify)
	________________	___________________		___________________	___________________
	________________	___________________		___________________	___________________
	________________	___________________		___________________	___________________
34	Add Lines 29 through 33.		42	Add Lines 35 through 41.
	This amount is your total net income.	____________________		This amount is your total expenses.	___________________
43	Subtract Line 42 from Line 34. This amount is your monthly net income after expenses.				43 ___________________

Step 6: Sign below

Under penalties of perjury, I state that this statement of assets and liabilities and other information is, to the best of my knowledge, true, correct, and complete.

Debtor’s signature______________________________________________________________ Date ___ ___/___ ___/___ ___ ___ ___

Spouse’s signature_____________________________________________________________ Date ___ ___/___ ___/___ ___ ___ ___

EG-13-I back (R-5/12)

This form is authorized as outlined by the Illinois Income Tax Act and the Retailers’ Occupation and related occupation taxes and fees acts.

Disclosure of this information is REQUIRED. Failure to provide information could result in this form not being processed.

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Lots of people generally make some errors when completing Address in this section. You need to go over whatever you type in here.

3. This next section is related to Monthly payment amount, a b, Present value, equity or asset Col A minus B, Liabilities Balance due, Step Complete the following, a b, a b, Pledgee or obligee, ﬁrst, payment, ﬁnal payment, Monthly expenses, Household monthly income, and Step Complete the following - fill in each of these fields.

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Form EG-13-I – Fill Out and Use This PDF

Form EG-13-I PDF Details

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