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Record #: O2011-1324   
Type: Ordinance Status: Failed to Pass
Intro date: 2/9/2011 Current Controlling Legislative Body: Committee on Finance
Final action: 5/24/2023
Title: Senior citizen sewer refund(s)
Sponsors: Shiller, Helen
Topic: PERMITS/LICENSE/FEE EXEMPTIONS - Refund of Fees - Senior Citizen Sewer
Attachments: 1. O2011-1324.pdf
Related files: R2023-766
f
 
 
Senioif Citizens Annual Refund Application
 
 
Note: *AII Fields Must Be Filled in
1
Claimant Name
First
Middle Initial
Last Name
2
Claimant Address
1 3Loo H LsP
3
Claimant City, State ft Zip Code
City
State
Zip Code
 
 
 
1f
 
 
Senioif Citizens Annual Refund Application
Note: *AII Fields Must Be Filled in1Claimant NameFirstMiddle InitialLast Name2Claimant Address1 3Loo H LsP3Claimant City, State ft Zip CodeCityStateZip Code
 
K J4
Claimant Telephone
Office
Home
Cellular
 
 
 
1f
 
 
Senioif Citizens Annual Refund Application
Note: *AII Fields Must Be Filled in1Claimant NameFirstMiddle InitialLast Name2Claimant Address1 3Loo H LsP3Claimant City, State ft Zip CodeCityStateZip Code
 
K J4Claimant TelephoneOfficeHomeCellular
 
5
Claimant Birthdate:
Must be 65 years of age, or older as of 3/11/2009 dd/mm/yyyy format
6
Property Tax Number:
Example PIN Number (XX-XX-XXX-XXX-XXXX)
piNlH\ -fST"-fuo"-(ooo-(1131
7
Water Account Number:
1                        xx-xx-xxx-xxxx-xxx format
8
Building Type:
'^^Condo
r
Townhouse
r
Co-op Apartment
9
Signature information on Next Page
 
 
 
Please print this and return application to your aldermanic office before July 1