City of Chicago Claim Form
Application For Senior Citizens Sewer Charge Annual Refund
Fill in the fields below and print form. Sign and take this to your alderman's office.
FOR OFFICIAL USE ONLY
CLAIM*_
WARD_
DATE_
STATUS_
R_
Note: *AII Fields Must Be Filled In
Claimant Name
5¦ NAsesn Annrth
Claimant Address
Claimant
City, State & Zip Code
, IL r &*£2-£>
Claimant Telephone
Office
Home
121
Cellular
Claimant Birthdate:
Property Tax Number:
PIN - - - -
Water Account Number:
Building Type:
Com Units
a
Res Units
_(print your name), the undersigned on
11
oath deposes and states that I am the applicant on this application, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund under Section 3-12-050 of the Municipal Code of the City of Chicago, that all water taxes, property taxes, and all other fees, penalties or assessments owed to the City of Chicago have been paid and that I understand I am subject to penalties for perjury or falsification herein.
OWNER SIGNATURE:.
5 -A/^^ AKy*^
DATE: ^^V^^S^/y^ W^^/d//
1 Edit Form
Please print this and return application to your aldermanic office before July 1
) 2007 Chicago City Council - Committee on Finanace. All Rights Reserved
Cook County Assessor s Office
118 North Clark Street, Chicago, IL 60602
PHONE: 312.443.7550 WEBSITE: WWW.COOKCOUNTYASSESSOR.COM
We are pleased to inform you that the Cook County Assessor's Office has issued a Certificate of Error which may affect yo:;r property taxes. Please note that the issuance of the Certificate of Erro. is only the first step in the process. The Certificate of Error becomes final only after the Assessor's Office or the Circuit Court approves it.
The information below details the recommended tax amount due for your property The recommendation assumes that the Certificate of Error will be finally approved. If the Certi...
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