Office of the City Clerk - Record #: O2011-2136

• Record #: O2011-2136
• Type: Ordinance
• Status: Failed to Pass
• Intro date: 3/9/2011
• Current Controlling Legislative Body: Committee on Finance
• Final action: 5/24/2023
• Title: Senior citizen sewer refund(s)
• Sponsors: Fioretti, Bob
• Topic: PERMITS/LICENSE/FEE EXEMPTIONS - Refund of Fees - Senior Citizen Sewer
• Related files: R2023-766

Date	Journal Page Number	Action By	Action	Result
5/24/2023		City Council	Failed to Pass
3/9/2011	114292	City Council	Referred

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Chicago City Council -
Committee on Finance - Application f... .
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 |10
9|Claimant Name Edith P Goldman |109|Claimant Address 910 S Michigan Avenue Uniyl613 |109|Claimant City, State & Zip Code Chicago , IL 60605 |109|Claimant Telephone Office 3123609899 Home 3123609899 Cellular 3127711789 |109|Claimant Birthdate: 01/07/1940 |109|Property Tax Number: PIN 17 - 15 - 307 - 036 - 1217 |109|Water Account Number: 58-87-255-887-25 |109|Building Type: Condo Com Units Res Units
11
i. EDIT/-) c^OLDh AN
_(print your name), the undersigned on
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 ofthe Municipal Code of the City of Chicago. that/SHwater taxes, property taxes, and all other fees, penalties or assessments owed to the city V Chicago have been paid and that I understand I am subject to penalties for perjury or falsificatyon heVeli
OWNER SIG DATE



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Please print this and return application to your aldermanic office before July 1
PAY ONLY THIS AMOUNT
$ 1,681.28
BV 12/13/10 (on time)
2009 Second Installment Property Tax Bi
Property Indea Number (PIN)
17-15-307-036-1217
Volume Code Tu Year (Payable in) TowfUhip
510 76027 2009 (2010) SOUTH CHICAGO
IF PAID LATE 12/14,11) -...