FOR OFFICIAL CLAIM#_ USE ONLY WARD__
: . DATE_
. STATUS_ R
APPLICATION FOR SENIOR CITIZENS SEWER CHARGE ANNUAL REFUND JER NAME:
Last Name First Name . M.I.
ygp AnORRSS: 6/0/ *£$£&/7^/ £ ^>£>B
Apt#
:AG.O, IL 606^0 HOME PHONE #: (773). 74/ -7/a^
JER BIRTHDATE: J? I £-/ /£ <</
T?R A rrOT-TNT NUMBER: ^5"c2 ^> 6r?" .¥£" 26> "3 id on water bill)
PERTY TAX NUMBER: id on property tax biff)
E OF STRUCTURE: (£XJ> Condominium Unit
2. ) Townhouse
3. ) Cooperative Apartment
/P/& £>OJ> the undersigned on oath depose and state that I am
print name here) -
applicant on this application, that I am the owner of record of said real estate property or that I have al or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund :r Section 3-12-050 of the Municipal Code of the City of Chicago. That all water taxes, property s, and all other fees.^enalties or assessments owed to the City of Chicago have been paid and that I :rstand I am subject to penalties for perjury or falsification herein.
NERSIP-NATURE: ^^^^ _DATE:- £,///£-&//
PLEASE RETURN TO YOUR ALDERMAN'S OFFICE BEFORE JULY 1
Alderman Mary Ann Smith 48th Ward
5533 North Broadway Chicago Illinois 60640 ATTN: Ann Felger
TSf RUCTIONS TO BE ELIGIBLE FOR THE SEWER CHARGE ANNUAL REFUND
u must be 65 years of age or older as of January 1 for the year you are applying;
u must be the sole owner, or owner in joint tenancy, or tenancy in:'tommon of the property;
u must occupy the property as your principal place of residence;
u must own a townhouse, condominium unit, or cooperative apartment that shares a common water
ree documents must be submitted with your application: You can choose 1 item from each of the lowing lists:
>st recent WATER LL
can obtain by ting your building don)
will verify the water or assessed account the water account r
2nd Installment of most recent tax bill indicating you are receiving the Senior Citizen Homestead Deduction;
or
Copy of the approved application for. the Senior Citizen Homestead Deduction;
Or
Assessor's Senior
Homestead Deduction (A.S.H.D.) Printout.
{which you can obtain by calling (312) 443-7550} . .
❖ PROOF OF AGE
♦t* Copy of drivers license
❖ Copy of State I.D. card *t* Copy of Passport
❖ Copy of Birth Certificate
:nior Citizen Sewer Charge Refund Application must be completely filled out and submitted c Alderman. If you apply by mail DO NOT send originals, SUBMIT COPIES.
have any questions, do not hesitate to call this office at (312) 744-9293, and ask for Colleen.
City of Chicago
Department of Revenue-Water Division
P.O. Box 6330
Chicago, Illinois 60680-6330
METERED ACCOUNT
Little leaks cause big bills.
Check for and repair leaks.
You must pay for all metered water.
Dec-09-2010 Dec-30-2010
CUSTOMER NAME/^\^^W^^ ^ ACCOUNT NUMBER?i
EAST POINT CONDO
452663-452663
Service Address: 940 W GLENLAKE AVE CHICAGO IL 60660
Summary of Charges for Oct-04-2010 thru Nov-01-2010
Total Current Water..................................................................................... $ 1457.79
Total Current Sewer.................................................................................. $ 1253.70
Penalty....................................................................................................... $ 0.00
Total Current Charges............................................................................ $ 2711.49
Previous Balance....................................................................................... $ 10055.27
Adjustments............................................................................................... $ 0.00
Payments................................................................................................... $ 10055.27
Total Due................................................................................................ $ 2711.49
Penalties accrue at a rate of 1.25% per month on late balances.
The pepartmeritofRevenue'sWater Division^
those.who qualify! Avoid Water shut off orhaveVyour servjce restored by. ^ for, more information.': ;:. ;
Meter Reading Details
1000 Cubic Feet = 7480 Gallons
Gallons
24657
25384
97.2
727
1230201D 00D452bb3[]4S2bb3 2 □ □□Q27114c] DDD027114ci 1
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT. ALLOW 5 DAYS FOR PAYMENT BY MAIL.
MAKE CHECK OR MONEY ORDER PAYABLE TO: City of Chicago
Department of Revenue-Water Division P.O. Box 6330
Chicago, Illinois 60680-6330 Service Address: 940 W GLENLAKE AVE CHICAGO IL 60660
^ACC.OUNTrNUMBERV
452663-452663
Dec-30-2010
$2711.49
17.1.5263 99976D11.p02'
i'>lli'>l>lliill'lll«lllil'l'ill-lill»lli'«'hl'l'iiili'ill
EAST POINT CONDO 6101 N SHERIDAN RD . CHICAGO IL 60660-2870
Amount Paid: $
12302DID □□□4S2bb3D4S2bb3 2 00D027114^ ■ ODD 02 7.114^ 1
Cook County Assessor's Office
118 North Clark Street. Chicago, IL 60602
Dear Taxpayer,
We are pleased to inform you that the Cook County Assessor's Office has issued a Certificate of Error which may affect your property t^p&r^^^^A9tJbe.is&\iancB of the Certificate _qf_ Error is only the first step in the process. The Certificate of ErrL? ^"
The information Certificate of En original tax bill.
You will receive; approval, your t| Cook County Tr|
■ $ Please review tl|
I
It is strongly a(c
F. W. WOOD 05-88 RUTH K. WOOD
6101 N. SHERIDAN RD E CHICAGO, IL 60660
2=1231
710
£291
3838
DATE .
PAY TO THE ORDER OF
^ - 7-_$ ?fS
.CHASE®
MEMO
»S0 7 iODOD I3i;
(VP
□□&a&5BiiMi"aa3a
Sincerely, " ' '*
//dames M. Houlihan
Cook County Assessor_
PROPERTY LOCATION: 6101 N SHERIDAN RD CHICAGO IL 60660
DATE: NOV. 19, 2010 CERTIFICATE OF ERROR NO.: 0011388 TAX YEAR: 2009
PROPERTY INDEX NUMBER:
Original Assessed Value: Original Equalized Assessed Value: Recommended Assessed Value: Recommended Equalized Assessed Value:
14-05-211-021-1134
29,944 76,914 29,944 47,113
If payment received or postmarked by:
11/19/2010 - 12/13/2010
12/14/2010 - 1/13/2011
1/14/2011 - 2/13/2011
2/14/2011 - 3/13/2011
Original tax payment due
2,363.99 2,399.45 2,434.91 2,470.37
Adjusted Tax payment due
985.10 999.88 1,014.66 1,029.44
Total Original Tax * Total Taxes Paid Original Balance Due *
3.558.81 Total Recommended Tax
1.194.82 Total Taxes Paid
2.363.99 Recommended Balance Due'
2,179. 1.194.
985.
92 82 10
* Please note, if the Certificate of Error is denied and additional money is due on the original bill, interest and penalties will be added to that delinquent amount.
19X
□
PAYMENT DUE Adjusted tax $
Certificate of Error Recommended Tax Bill
Bring entire bill when paying by person. Please do not use on-line checking systems to pay. 12/13/2010
Original tax due:
Amount Paid
$
Check Ulis box to chang>maUilia/addrejs (where bill Is sent) and complete form on back.
2,363.99
Certificate of Error No.:
» Properly Index Nomber (PIN)
Volume
14-05-211-021-1134
472
'Write PIN and Volume on check made payable to Cook County Treasurer.
□ 00023b3TiD m05E11021113M7 0D0Q23CH450 0QGDr343MT10 □□□□247Q372
COOK COUNTY TREASURER PO BOX 4488
Carol Stream IL 60197-4488
RUTH K WOOD
6101 N SHERIDAN RD E
CHICAGO IL 60660-2870
lM05211021113M/Q/0VF/000rj23b3cH/r2
m
Jesse White - Secretary of State
NUMEER ■ ISSUED . ■ EXPIRES
.:o02-2M3\ggSg^
RUTH K WOOD 6101 N SHERIOAN RO EAST CHICAGO IL60660
Birthdate 03-21-34 Female 5V6' 120 lbs BRN Eyes Restrictions Type Class BF ORG D
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