Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
111111' I -111111 -1 -11' 11 -1111111111 -1' I >11 f 11'' 111111111111'1 -' -11
Status:_ Reason:.
009*001*******5-DIGIT 60615 JOHNSON, WAYNE T. 1765 E55TH ST APT FI CHICAGO, IL 60615-5985
Claim Number: 1021413
Index Number: 2013103007 0000
Water Account Number: 552491552491
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
0
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhal you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il lo your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 waler 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
I Ito4^* * 7~- ^%/u3<?A) the undersigned, on oath,
Please Print Name
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
,|,||,l|||||||||||l|l||||,|ll|l,|l|l,|l,|.,|||l|,|||l,||.|l,l
Status:_ Reason:
009*001 *******5-DIGIT 60615 MEHTA, BHARAT V. 1755 E55TH ST APT 802 CHICAGO, IL 60615-5991
Claim Number: 1019830
Index Number: 2013103011 0000
Water Account Number: 552491552491
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oalh.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi 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 waler 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE.
Alderman Edward M. Burke Cliairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
llll"lllllllllllllH'lllIMllllllrlIHIlIMI
Ill
II
II
II
Mil
Status:_ Reason:
018*001*********3-DIGIT 606 DAVIS, MARGARET 6638 S GREENWOOD AVE APT 2A CHICAGO, IL 60637-4340
Claim Number: 1020172
Index Number: 2023124019 0000
Water Account Number: 695391555433
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and dale this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 oflhe Municipal Code ofthe 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
I M A3? & AS? £T T) A \/XS the undersigned, on oath,
Please Print Name
».»gjjji,228
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:__
Intro. Date:_
.II,.!!,!!,...,,!!!.!!!,),!!.!!.,..!!!!,,,!!!.,)!!,!,.!!!
Status:_ Reason:.
018*001*********3-DIGIT 606 MANNING, MARY L. 1700E56TH ST APT 1210 CHICAGO, IL 60637-1934
Claim Number: 1018925
Index Number: 2013102029 1099
" Water Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I MfrlM fl>IAsyw')/)6- the undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund under Section 3-12-050 of the Municipal Code of the City of Chicago, that all water taxes, property taxes, and all other fees, penalties or assessments owed to the City of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
-$Sg»»>228
Alderman Edward M. Burke Chairman
City of Chicago
Telephone 312-744-3380
February 18, 2011
OO-l-l'lO
■ir >l>r l-il,lllhl-lllili-(-llilll-t--lllll'lii-'ii-MII-'llil1
018*001*********3-DIGIT 606 BYRD, ARNIE M. 1700 E 56TH ST AFT 3407 CHICAGO, IL 60637-5098
For Official Use Only: Ward: ■_■_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1016471
Index Number: 2013102029 1316
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath.
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 pefjury of falsification herein.
OWNER SIGNATURE
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 201 1
For Official Use Only:
Ward:_
Intro. Date:_
||,||ll|,l|||||ll||,,||||||ll,,lll||||||,||l|,,ll|ll.l|.|ll
Status:_ Reason:
019*001*********3-DIGiT 606 BROWNLEE, BRADY 6937 S CRANDON AVE APT 8E CHICAGO, IL 60649-2944
Claim Number: 1003578
Index Number: 2024419018 1041
Water Account Number: 300810012009
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
undersigned, on oath,
Please Print Name
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
018*001*********3-DIGIT 606 HANNA, JULIETTE 1700E56TH ST APT 409 CHICAGO, IL 60637-5063
Status:, Reason
Claim Number: 1016447
Index Nu mber: 2013102029 1018
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January. 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I^TU1 \E Y~\BmN fi_the undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 Cily 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURl
DATE
^3, ^ I \
228
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
lilnTll'll"llil,lillliliriihllil,"liilrliil,l,iiliil
Status:_ Reason:.
018*001*********3-DIGIT 606 SNYDER, DOLORES J. 1400 E 56TH ST UNIT 2-W CHICAGO, IL 60637-1852
Claim Number: 1020413
Index Number: 2014203044 1002
Water Account Number: 552685552685
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath.
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 tcypenalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
£ fji^g^tS' 228
City of Chicago
Commiltee on Finance
Alderman Edward M. Burke Citv Hall Room 302 60602 Telephone
February 18, 201
I'l-'-'liii'-l'i'lXi'li-'li'l'nilll'llli'lil'li'-i1-11!-1-
019*001*********3-DIGfT 606 ZANSmS, JR., PETER P. 6939 S CRANDON AVE APT 5F CHICAGO, IL 60649-2943
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1018831
Index Number: 2024419018 1024
Water Account Number: 300810012016
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I ^?ErrgRf?.^ANSlT\<s "X^ the undersigned, on oath, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi 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 of falsification herein.
OWNER SIGNATURE^^OZ ^-j^L^uJ^, J DArE Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
$Sggj»228
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
lOii'ilill'll'XT-ii-'M'inli'-'ii'n'l-ii1-1111-1!!1!
018*001*********3-DIGIT 606 CARTER, ELEANOR F. 1700 E56TH ST APT 508 CHICAGO, IL 60637-5072
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1021278
Index Nu mber: 2013102029 1027
Water Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the Cily Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I fElfc$hl0f\ f, Qfflt^xte undersigned, on oalh, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estale 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 of falsification herein.
OWNER SIGNATURJ^/^^Aa/ (^fa^iS DATE 3 ' 2 S' ' 11_
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: _
Intro. Date:_
|J|.|I|||JI|m||||I||.II|||||I.I||.|I.I.|.I|II|...I|II|
Status:_ Reason:.
018*001*********3-DIGIT 606 WALTZ. ELIZABETH R. 5617 S DORCHESTER AVE APT 2N CHICAGO, IL 60637-1749
Claim Number: 1020468
Index Number: 2014210005 0000
Water 'Account-Number: 552642552642""
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January. 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I £i-i?.A\{\£-n\ L^AWT& the undersigned, on oath,
Please Print Name
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 201 1. that 1 am the owner of record of said real estate properly 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
OWNER SIGNATURE.
DATE
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February;18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
i-lhll-ilii-linill-lilMlni-llllll-l-lnlllirl-illi
Status:_ Reason:.
018*001*********3-DIGIT 606 GRANT. JEAN M. 1406 E 56TH ST UNIT 2 CHICAGO, IL 60637-1826
Claim Number: 1020414
Index Number: 2014203044 1008
Water Account Number: 226040163601
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il to your ward office before July 1, 2011.
I ~S~i^CLr\ Crr~Qjr\\~_tne undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January l, 2011, that I am the owner of record of said real estate properly 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce il on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Prinl Name
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February. 18, 2011
-1111111 -11' 111' 1111'' 111 *' * 11 >1 > I' I 1111' 1111'' 1111 -11'11 -1 - - < -1
009*001*******5-DIGIT60615 THOMPSON, WILLIAM A 1401 E55TH ST APT 505N CHICAGO, IL 60615-5476
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1023464
Index Number: 2014202076 1040
Water Account Number: 552702552702
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 lhal I understand I am subject to penalties for perjury of falsification herein.
OWNER SIGNATURE JtijlL-/? DATE ZMfZOII
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Committee on Finance
Alderman Edward M. Burke Cily Hall Room 302 60602 Telephone
February 18, 2011
i > 1111111 - -111 - -111 -1 11 - -111 - -11111 -11 - - -111M11 -1 -111M11 -11111
018*001*********3-D[GiT 606 MCCLENDON, MABEL B. 6634 S GREENWOOD AVE CHICAGO, IL 60637-4342
Index Nu mber: 2023124019 0000
Water Account Number: 300820215003
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1011944
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commillee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I$$9, £L B, MCdi- £A/A OrJ the undersigned, on oath, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1. 2011, that I am the owner of record of said real estate properly 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 of falsification herein.
OWNER SlGNATURE^^^r^ . W'&&4lJI>u DATE cK*- //
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 CORY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
l-'o-i-l'-'l-lr'IN-'iiilil-'nilil1!1!1!1!1!!!1-!!1!!!1-1
Status:_ Reason:
009*001 *******5-DIGIT 60615 JUDAS. ILSE 1765 E 55TH ST APT J3 CHICAGO, IL 60615-5926
Claim Number: 1021173
Index Number: 2013103007 0000
Water Account Number: 552491552491
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer,Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it lo your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011, 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 lo the City of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours, v-/ Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
the undersigned, on oath.
Please Print Name
DATE.
=^«|*>228
Alderman Edward M. Burke Chairman
February 18, 2011
l."l||l...|l.|l|ll.||I.T."|l||ll...l|.|'||-|||-
018*001 *********3-DIGJT 606 HYDE, DAVID
6634 S GREENWOOD AVE APT 2B CHICAGO, IL 60637-4342
Index Number: 2023124019 0000
Water Account Number: 300820215003
City of Chicago
'llll'll11'
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1011945
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as.your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 201'
^ the undersigned, on oalh.
Please Print Name/
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 Lalrn subject to penalties for perjury of falsification herein.
OWNER SIGNATURE
DATE
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
February 18, 2011
City of Chicago
liMMiillilli-l-llllll-iilir>-ll-i-i-i-llilNiiillll-lil
018*001*********3-DIGIT 606 MOORE, HENRY L 1450 E 55TH PL APT 518S CHICAGO, IL 60637-1893
Index Number: 2014202076 1427 Water Account Number: 552702552702
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1005113
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance musl verify that you occupied this property, as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
//{/l/h u Lt JL/J ftCPh&ht undersigned, on oath, Erlease Print Name
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011 that I am the owner of record of said real estale property or that I have a legal or equitable interest therein, lhat 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 waler laxes, 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 of falsification herein.
OWNER SIGNATURE
Very Truly Yours,
Edward M. Burke
^^uC DATE 2-7-1- //
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: _
Intro. Date:_
||,||||ll|ll,l,l|l||,l||||,|l||,|lll|||ll|||,||,l|,|,||ll||,|
Status:. Reason
018*001*********3-DIGIT 606 SUGENO,HENRY 1700E56TH ST APT 1002 CHICAGO, IL 60637-5077
Claim Number: 1017359
Index Number: 2013102029 1071
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to ihe City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under ihe Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
1 H E-H'jS.Y RU^^lAQ the undersigned, on oath, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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, thai 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 topenalties for perjury of falsification herein.
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: _
Intro. Date:_
I,!!!!!,,!.!!,,.,!!,!,!,!,,,!!!!.!!!,,.,!!!,,!!,,,,!!,!!,!!!,!!
Status:_ Reason:.
018*001 *********3-DIGIT 606 PINKSTON, ISABELLA 6632 S GREENWOOD AVE APT 3B CHICAGO, IL 60637-4343
Claim Number: 1011949
Index Number: 2023124019 0000
Water Account Number: 300820215003
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and dale this application and return it to your ward office before July 1, 2011.
undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, thai 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATUR1
■-y^ DATE - 2A- //
City of Chicago
Commiltee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
Tl||.|.l.|l||llln||.|||l.|l|l|l|l|||||ll.||||ll||||l||||l
019*001*********3-D[GIT 606 WEBB, KENNETH 6933 S CRANDON AVE CHICAGO, IL 60649-1734
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1003586
Index Number: 2024419018 1009
Water Account Number: 300810012009
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
the undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, lhat 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 Cily 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^ubject to penalties for perjury of falsification herein.
OWNER SIGNATURE.
TATE
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN I COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
City of Chicago
Telephone 312-744-3380
February 18, 2011
I! 1111111' 11111!'1111 h' 11 - - -1111'111 -1M'111111' -1111 -
019*001 *********3-DIGIT 606 BROWN, WILLIE B. 2054 E69TH ST APT IA CHICAGO, IL 60649-1671
'l'l
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1006352
Index Number: 2024408025 0000
Water Account Number: 300810003906'
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate properly 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, lhat 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 of falsification herein.
OWNER SIGNATURE ^V^^^Ls-J ^, ^tXn^ DATE ~ 2y<=^ ~ / \
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN I COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
February 18, 2011
City of Chicago
'il"iil,'l,'il"l,,i'i"'i'lilrll',il'l""ir""',ll"r'lr
018*00l*********3-DIGIT 606 SANDERS, JACQUELYN / ~-583eS STONY ISLAND AVE #4?2G CHICAGO, IL 60637-2058
Index Number: 2014223032 0000 Water Account Number: 300820429406
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1020207
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I
Please Pnnt Name
he undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, lhat 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 undersj^nd I am subject to penalties for perjury of falsification herein.
OWNER SIGNATURE.
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
c<4j^^^£> 228
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 201 I
For Official Use Only:
Ward:__
Intro. Date:_
"i-o-inir'llliil-h'lxo-'-ii-liiil'-ll'iirliMli
Status:, Reason
018*001*********3-DIGFT 606 BALL, CARRIE L 1450 E 55TH PL APT 724S CHICAGO, IL 60637-1815
Claim Number: 1023358
Index Number: 2014202076 1483
Water Account Number: 552702552702
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I flfl/L/LlZ. /_. , ./^//__the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, lhat 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71 ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
*g§^22e
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
018*001*********3-DIGlT 606 RANDOLPH, CHARITY 1450E55TH PL #917 CHICAGO, IL 60637-1877
Status:_ Reason:.
Claim Number: 1011986
Index Number: 2014202076 1422
Water Account Number: 552702552702
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If ihe property meets these requirements, you must sign and.date this application and return it to your ward office before July I. 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
I C/7 A/ZfTy 'the undersigned, on oalh,
Please Prinl Name
OWNER SIGNATURE!
DATE -<3.^f~ //
Alderman Edward M. Burke Chairman
City of Chicago
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1016697
February 18, 2011
■ ■ i !■ ■ i i i 1 ■ 11 ■ i ■1 ■ i1 ■ ■ ■ ■ 11 ■ 11 -1 ■ ■ i ■11 ■ i ■ i ■ 111 ■ i ■ i ■ 11 ■ ■ 111 ■1 ■ ■
018*001*********3-D[GIT 606 PERCELL, EMERY A 1700E56TH ST APT 401 CHICAGO. IL 60637-5063
Index Nu mber: 2013102029 1010
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
P^ase Print Name
Jhe undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 firff perjury of falsification herein.
OWNER SIGNATURE
DATE
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only :
Ward:____
Intro. Date:_
Status:_ Reason:
009*001*******5-DIGIT60615 PHILLIPS, JOSEPH J. 5400 S HYDE PARK BLVD APT 7A CHICAGO, IL 60615-5823
Claim Number: 1023192
Index Number: 2012113052 1007
Water Account Number: 539700539700
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
.the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 all waler 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
DATE
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room .302 60602 Telephone
February 18, 2011
rl'M'lihl-'lh "il--i-iirilllllllii'-llnlil
018*001*********3-DIGIT 606 STRAUSS, CAROL D 1700 E56TH START 301 CfflCAGO. IL 60637-1933
11 - -1111 <111
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1021732
Index Number: 2013102029 1001
Water Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I Qj\ROL D, S'7""/?ArU5^undersigned. on oath, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 Secdon 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 of falsification herein.
OWNER SIGNATURE ^O^lo-^ /&< Sfe-A^a*-- DArE P^J^, JL 3 JZ^/Z
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
i»i;iiu
1. 1111 11... I., |. 11111,11 I,. I. |,. 11... 11111 |. I,, 111 f 111
009*001*******5-DIGIT60615 WILLIAMS, KALE A. 5457 S HYDE PARK BLVD APT IN CHICAGO, IL 60615-5806
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1020689
Index Number: 2012114043 1001
Water Account Number: 539654539654
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented lo the City Council by: LESLIE HAIRSTON of Ward 05.
To.determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under ihe Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to ^ your ward office before July 1, 2011.
I \ rVfc(g A. UJi lilCLVft'S the undersigned, on oath, V Please Print Name
\
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1. 2011, lhat I ain 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 Cily of Chicago} that all water taxes, property taxes, and all other fees, penalties or assessments owed to the City of Chicago have been pai<ji and that I understand I am subject to penalties for perjury of falsification herein.
OWNER\ SIGNATURE,
\ ■ .....
Very Tryly Yours,
i i
Edward M. Burke
i
MAIL '1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
i
Alderinan LESLIE HAIRSTON Attn.'KIM WEBER 23'25 E./lST STREET hicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
^llllll,!,!!.!,,!!.,!,!!.!!,.!,!.,...!.!!.,.,!.!!!,,!!,,!,,
Status:_ Reason:.
0l8*001*********3-DIGiT 606 LANZL, ELISABETH 5750 S KENWOOD AVE CHICAGO, IL 60637-1744
Claim Number: 1006681
Index Number: 2014215028 0000
Water Account Number: 226040 i 43508
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I cc j s e,a i) e^-j-i-. L^Cl'h'2-l the undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011. 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 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
Status:, Reason:
ERICKSON, IATSER C. 5624 S DORCHESTER AVE CHICAGO, IL 60637-1722
Claim Number: 1011870
Index Number: 2014209030 1002
Water Account Number: 2260401 19209
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January; 2011. If the property meets these requirements, you must sign and date this application and return il lo your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011. 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
i IATSER C. bRlCKSOH
the undersigned, on oath,
Please Print Name
'«3g?*>228
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
■ -"llll'llll-
|1|,|,1||.l||l|l|l|,,.,l||||ll1
018*001*********3-DIGIT 606 FREEDMAN, DOROTHY R. 1159 E56TH ST APT 1 CHICAGO, IL 60637-1532
''■I'M
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1018389
Index Number: 2014112002 0000
Water Account Number: 300820430000
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhal you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I OQPof-hy p? Fregd mferu>idersigned. on oath. Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 ofthe City of Chicago, lhat all water taxes, properly 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 of falsification herein.
OWNER SIGNATUR Very Truly Yours
gW^g^e-. date
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: 1
Intro. Date:_
I,!.!,!.!,!.!.!,,!!!.!!.,,!!!,,.,,..!!.,!,.,,.!!!,!!!,
Status:_ Reason:.
018*001*********3-DIGIT 606 FORD, MARGARET E 1700 E 56TH ST APT 3802 CHICAGO, IL 60637-5802
Claim Number: 1021731
Index Number: 2013102029 1351
Water Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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, lhat 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
.the undersigned, on oath,
Please Print Name
DATE
Alderman Edward M. Burke Chairman
February 18, 2011
City of Chicago
■||l,'l,,IIIU,l|-|l,lll,UllT,lllllllllll,lllll"l',l,,l11'
018*001*********3-DIGIT 606 TIFT, VIOLET E.
6636 S GREENWOOD AVE APT 3A CHICAGO, IL 60637-4341
Index Number: 2023124019 0000
Water Account Number: 555433555433
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1019356
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I
VlflLFT. ETtPf
the undersigned, on oath,
Please Print Name
depose and slate that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
DATE
OWNER SIGNATURE Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only: Ward:
Intro. Date:_
11 - -111 - ] i - -111 -1111111! 11111M11 -11 k i1 - -1 - < -1 - -1 - -1 -1111 -111111
. Status:_ Reason:.
018*001*********3-DIGIT 606 NICHOLSON, DORIS I700E56TH ST APT 1209 CHICAGO, IL 60637-5079
Claim Number: 1016895
Index Number: 2013102029 1098
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented lo the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il to your ward office before July I, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011. that I am the owner of record of said real estate property or that I have a legal or equitable interesi therein, that I am 65 years of age or older, and otherwise qualify for a refund under Secdon 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL I SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on vour behalf. RETAIN 1 COPY FOR YOUR RECORDS
VFIS f\>liQsV\(ll'Z>/DtA the undersigned, on oath.
Please Print Name
City of Chicago
Commiltee on Finance
Alderman Edward M. Burke Cily Hall Room 302 60602 Telephone
February 18, 2011
noJJSJ
|||,l|,l||ll,l|||ll||,l,|rll|,l,|||lll,.|ll.l,l,|,,l|
018*001*********3-DIGIT 606 WEINTRAUB, D. KATHRYN 1700E56TH ST APT 709 CHICAGO, IL 60637-5074
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1018689
Index Number: 2013102029 1048
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I rffi, K*%t\iJ Wiih/1'rfJJol? the undersigned, on oath, Pleafse Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011, 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 Cily 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 of falsification herein.
OWNER SIGNATURE.
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Comniittee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
*SsS»>228
Alderman Edward M. Burke Chairman
City of Chicago
.312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
111' -111 -1 m i - -11111111 11111 -111 >1111 -1111 11M - -11 -11H11111111
Status:_ Reason:.
018*001*********3-DIGIT 606 KEEN, LORETTA 1700 E56TH START 3101 CHICAGO, IL 60637-5096
Claim Number: 1022618
Index Number: 2013102029 1280
Waler Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath,
depose and state that I am the applicant in the application, thai this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, thai 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 Lam subject to penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Cliairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
','"llill,'rlli'"l,"'ill'i"i,'i"i"lrl,ll""i"ilnil"i
Status:_ Reason:
018*00l*********3-DIGIT606 BURKS, MARY P. 5530 S SHORE DR APT 2C CHICAGO, IL 60637-1921
Claim Number: 1018401
Index Number: 2013103009 0000
Water Account Number: 300820427905
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011, that I am the owner of record of said real estate properly or lhat 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 lo the City of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
».*Sj^<»228
City of Chicago
Alderman Edward M. Burke Cliairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: _
Intro. Date:_
-111111 n i ■ ■1 ■ 11 ■ 11 ■ ■ ■11111 ■1 m 11 ■11 ■1 ■ ■1 ■ i1111 ■1 ■111 ■ 111 ■ i ■ i ■ *
Status:_ Reason:.
018*001*********3-DIGIT 606 BRUSMAN, NOEL S. 1361 E57THST CHICAGO, IL 60637-1758
Claim Number: 1016626
Index Number: 2014216045 1021
Water Account Number: 3002891 19807
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
OWNER SIGNATURE "77 o^&> j3- £>&u#>w>><^ DATE_2 - 2,3 ~2 G < I
Very Truly Yours. Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
I N 0 £ L S 6gvj An' the undersigned, on oath,
Please Print Name
City of Chicago
Alderman Edward M. Burke Cliairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
1 -1111 -111111 r1 h -1111111111111 -1 - - - -11111111 - -11111[ i11111 f 11 - H
Status:_ Reason:.
009*001*******5-DIGIT60615 BARKER, LULA M. 5467 S ELLIS AVE 1 CHICAGO, IL 60615-5058
Claim Number: 1019165
Index Number: 2011329001 0000
Water Account Number: 542382542382
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/lownhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhat you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il to your ward office before July 1, 2011.
R-__the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
DATE 2-23'//
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
■11. ■1 -1111111 ■111 ■ 11 (i ■«■ ■ i ■f i ■ n i11111. i u ■1 ■ ■ ■11111.11 ■ i ■ 111 ■1
Status:_ Reason:.
018*001*********3-DIGiT 606 SMITH, DORIS J. 1400 E 55TH PL APT 100IS CHICAGO, IL 60637-5224
Claim Number: 1020107
Index Number: 2014202076 1279
Water Account Number: 552703552703
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the Cily Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I Jll^ <yf' *SI "/"/'/he undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, lhat 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, lhat 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 of falsification herein.
Very Truly Yours. Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
iHHiilir'il-'i'l........h -111 - -1111111111 -11111 n i -11 - -1
Status:_ Reason:.
018*001*********3-DIGIT 606 DICKSON, BETTY 1400 E 55TH PL APT.#616/SOUTH CHICAGO, IL 60637-1876
Claim Number: 1020972
Index Number: 2014202076 1410
Water Accouiii Number: 552703552703
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and slate that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 lo the City of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago,-IL 60649
Please do not send it to the Committee on Finance: your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
.the undersigned, on oath,
Please Print Name
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
'Mrl'-irli'"^!'!!'!'!''!''!'-'"!-!!.....In11!'1!1"!!1!!
Status:_ Reason:.
018*001*********3-DIGIT 606 ALBRITTON, MARIE B 5550 S SHORE DR APT 907 CHICAGO, IL 60637-5033
Claim Number: 1021733
Index Number: 2013102029 1154
Water Account Number: 552497552497
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il to your ward office before July 1, 2011.
rs the undersigned, on oath,
depose and slate that I am the applicant in the application, lhat this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18; 201 I.
For Official Use Only:
Ward:__
Intro. Date:_
'IMiIi'i'iI'-IIi'-iiii'IM-'IiII'iiii'i-'iiiI'IIiI-'-IIIt1
Status:_ Reason:.
009*001*******5-DIGIT60615 MAYERS, BARBARA W 5300 S SHORE DR APT 107 CHICAGO, IL 60615-5727
Claim Number: 1022753
Index Number: 2012112069 1073
Water Account Number: 539698539698
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM"WEBER CJ£E& 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
the undersigned, on oath,
Please Print Name
City of Chicago
Alderman Edward M. Burke Cliairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only: Ward:
Intro. Date:_
018*001*********3-DIGIT 606 RAYNER, ALICE L. 1700E56TH ST APT 2302 CHICAGO, IL 60637-1935
Status:_ Reason:
Claim Number: 1016478
Index Number: 2013102029 1201
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
/ Q\.&- £* r> £\ Wfl/'fCthe undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Chairman
City of Chicago
Telephone 312-744-3380
February 18, 2011
«i i11 >1 ■■11111 -111111 ■ i ■ 111 ■ ■ ■111 - -1111111■i11■■1111 ■ i11 ■ i«11 ■
018*00l*********3-DIGiT 606 BALTHAZAR, DON J. 1700E56THST APT 3104 CHICAGO, IL 60637-5096
For Official Use Only: Ward:
Intro. Date:_
Status:_
Reason:_
Claim Number: 1017227
Index Number: 2013102029 1283
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05. .
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
the undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011 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 w:ater taxe^' property taxes, and-all other fees, penalties or assessments owed to the City of Chicago have been paid and that I undcwtaiML sub^t/c/penalties for perjury of falsification herein.
OWNER SIGNATUR
Very Truly Yours,
a/2V///
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
».!Jij«J*.228
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:._
Intro. Date:_
I J111" I f >111111 ■ I i I ■ > ■11 ■ 11 ■ 111" ■11 ■ ■ ■ i ■ ■ i ■ ■ 11 i ■ i J > 111M 111
Status:_ Reason:
018*001*********3-DIGIT 606 FULLER, GLADYS O. 1400E55THPL#916 CHICAGO, IL 60637-1876
Claim Number: 1006849
Index Number: 2014202076 1190
Water Account Number: 300820437001
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state thai I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate properly 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 Ihe City of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71 ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN I COPY FOR YOUR RECORDS
GLAb^s a Pullsf{
.the undersigned, on oath,
Please Print Name
City of Chicago
Commillee on Finance
Alderman Edward M. Burke Citv Hall Room 302 60602 Teleplione
February 18, 2011
MI> 11 -11 < 11 -111 I' 111111 *1111 -11J111'111'1111'1111 * -11111 ^> -' 111
018*001 *********3-DIGIT 606 JOHNSON, ROBERT 5648 S DORCHESTER AVE APT 3E CHICAGO, IL 60637-1751
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1023468
Index Number: 2014209031 1015
Water Account Number: 552697552697
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
, RoB^T - V. Totl.^tf?eddersigned. on oath, Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1. 2011, 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 of falsification herein.
OWNER SIGNATURE \^/^i^f-f~l^v^x^--DATE_ s^J<Z2/
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
'^gs^228
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
in)
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
illilullll-iu-lilllllilll-li-ililliinllMllli'liiull
Status:_ Reason:.
018*001 *********3-DIGIT 606
WILLIAMS, JOHNN1TA D. 1700 E56TH ST APT 1208 CHICAGO, IL 60637-5079
Claim Number: 1018479
Index Number: 2013102029 1097
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented lo the Cily Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and dale this application and return it to your ward office before July 1, 2011.
_the undersigned, on oath.
depose and stale that I am the applicant in the application, that this is my principal placeof residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi therein, thai 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 Cily 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 understancH am subject lo penalties for perjury of falsification herein.
Very Truly Youref / Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATUR1
^3^*228
Alile.rman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
'11 -1 - M111111 j I'1' 11 (11 - - -11111 < -1111 f 1111 - h 1111'111' -1' H1' 111
Status:_ Reason:.
018*001*********3-DIGIT606 SC1PIO, CHRISTINA L. 1700E56THST APT 2608 CHICAGO, IL 60637-5070
Claim Number: 1016456
Index Number: 2013102029 1237
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I C-V-*ixiSh Mfl /- » i pin the undersigned, on oath.
depose and slate lhat I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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, thai 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE^
«,-jtS3>i>228
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For OfficialUse Only:
Ward:_
Intro. Date:_
1111 > - -1' -1 -111 -111 -11J - - - < > i > 11 > i - - e -1111 e > > >' 11 > i > j -11 -1111 r 111
Status:_ Reason:
018*001*********3-DIGJT 606 CHERCFD, JUDY
5619 S DORCHESTER AVE APT 65 CHICAGO. IL 60637-2099
Claim Number: 1021729
Index Number: 2014210005 0000
- Water Account Number: 552642552642
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
undersigned, on oalh,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or lhat 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 lo penalties for perjury of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance: your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
DATE ' 2. - 1-M--( 1
■^g?*22e
Alderman Edward M. Burke Chairman
City of Chicago
Telephone 312-744-3380
February 18, 2011
i i riii■■i,i. -1111, i,,.i.i--1... 111111-1,. 11. -,.
009*001 *******5-DIGIT 60615 COHN, CARL M. 5460 S HYDE PARK BLVD CHICAGO, IL 60615-5802
■'it'i-
For Official Use Only: Ward: ■._
Intro. Date:_
Status:_
Reason:_
Claim Number: 1007016
Index Number: 2012113046 1006
Water Account Number: 224040138105
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
jhe undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi therein, lhat 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 of falsification herein.
OWNER SIGNATURE, Very Truly Yours.
^.^LcS^U^- DATE ^/^/W/
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
l-liii-liliililillllnrl-Ti-ulhillllrllll-ill-liTlil
Status:, Reason:
018*001*********3-DIGIT 606 VANDERMEULEN. NORMA W. 1700 E56TH ST APT 908 CHICAGO, IL 60637-5014
Claim Number: 1016452
Index Number: 2013102029 1067
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements,,you must sign and date this application and return it to your ward office before July 1, 2011.
I /^JeHWA \J VKH Dtrfc M& ukld the undersigned, on oath.
depose and state lhal I am Ihe applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, lhat 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 of falsification herein.
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Comniittee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATU
Very Truly Yours,
Edward M. Burke
Alderman Edward M. Burke Chairman
City of Chicago
February 18, 2011
I,,,!!!,,.,!,,!,,,,!!,,!!!,,,!!,!!,!,,!!!!!!!!,,!,!!!,!.,!
018*001 *********3-DIGIT 606 GRADY, JOHN M. 5840 S STONY ISLAND AVE CHICAGO, IL 60637-2063
Index Number: 2014223032 0000
Water Account Number: 300820429406
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1009891
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
Please Print Nama
Jhe undersigned, on oalh.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January I, 2011, 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 understaful I am subject to penalties for perjury of falsification herein.
DATE ^^2)^ //
Very Truly Yours
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
llliuliiilillil-lllrl-ililllllll-lil-lh-li-ilil-il-illl
Status:_ Reason:.
018*001*********3-DIGIT 606 WILSON, ALTAFERN 1450E55TH PL APT 1017S CHICAGO, IL 60637-1853
Claim Number: 1020037
Index Number: 2014202076 1423
Water Account Number: 552703552703
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Comniittee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
3 Or/ the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325.E. 71ST STREET, Chicago; IL. 60649 ' A \.
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE!
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
■-■illl-ii-lh-'-'-iil"!--^!!-^"^'!!-!!!-'!!!!'-!!!!-1
Status:_ Reason:.
018*001 *********3-DIGIT 606 PATTERSON, RUTH 1302 E56TH ST #2 CHICAGO, IL 60637-1712
Claim Number: 1006685
Index Number: 2014201079 1048
Water Account Number: 300820423408
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and .date this application and return it to your ward office before July 1, 2011.
I Ru~Th{ L, PATrCTRSON the undersigned, on oath,
depose and state that 1 am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate properly 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, lhat 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
«.*^^C»228
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only: Ward:
Intro. Date:_<_
Status:_ Reason:.
OGASAWARA, MINORU 1700 E56TH ST APT 1402 CHICAGO, IL 60637-5080
Claim Number: 1016479
Index Number: 2013102029 3333
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If Ihe property meets these requirements, you must sign and date this application and return il to your ward office before July 1, 2011.
I /*f/A/Q/ZU (TkftZAUj/i £.n the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 Cily 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 of falsification herein.
Please Print Name
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
lllillll-iiillliiilililli-lniNlli-lll-ll-hll-l-lilhr
Status:_ Reason:.
009*001*******5-DIGIT60615 TORCZYNSKI, ELISE 1765 E55TH ST APT H2 CHICAGO, IL 60615-5926
Claim Number: 1018290
Index Nu mber: 2013103007 0000
Waler Account Number: 300820439.014
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January. 2011. If the properly meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN I COPY FOR YOUR RECORDS
the undersigned, on oalh,
Please Print Name
DATE
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
rliil"ilh,lill'll""llll'lll,l'"l'iilirllill,lll,illi'lll
Status:_ Reason:.
009*001 *******5-DIGIT 60615 BOO, MAUREEN
5401 S HYDE PARK BLVD APT 901 CHICAGO, IL 60615-5836
Claim Number: 1019623
Index Nu mber: 2012114054 1008
Water Account Number: 300620923863
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhat you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I '^OO , M.&MAa&~i>^-- the undersigned, on oath,
depose and state lhal I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago. IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE.
ATE.
"'■SH?*-228
Alderman Edward M. Burke Chairman
February 18, 2011
City of Chicago
iiii-IIIIii-'I-I-iIiIIiIItI'i-'I'i'-'I-Ii-i-'i-II'Ii-Ii11
018*001*********3-DIGIT 606 GILL, RICHARD R 1700E56THST APT 1109 CHICAGO, IL 60637-5078
Index Number: 2013102029 1088 Waler Account Number: 552497552497
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1022856
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify lhat you occupied this properly as your principal residence on the first day of January, 2011. If the properly meets these requirements, you must sign and dale this application and return it lo your ward office before July 1, 2011.
the undersigned, on oath.
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011 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 Cily of Chicago-have been paid and lhat I understand I am subject to penalties liar perjury of falsification herein.
DATE
OWNER SIGNATURE. Very Truly Yours, Edward M. Burke
MAIL I SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
lllil-llll-illi-llilnilliililll-llii-liliil-llilhii-rl
Status:_ Reason:
018*001*********3-DIGIT606 NELSON, KAY H 5529 S UNIVERSITY AVE APT 3E CHICAGO, IL 60637-1534
Claim Number: 1022609
fndex Nu mber: 2014106005 0000
Water Account Number: 554287554287
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this properly as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, lhat this is my principal place of residence as of January 1, 2011, 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 Cily of Chicago have been paid and that I understand I am subject to penalties for perjury of falsification herein.
Very Truly Yours. Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
the undersigned, on oalh,
Please Print Name
Mclennan Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 201 1
For Official Use Only:
Ward:_
Intro. Date:___
111 -11' 11 - -1111 -'1' 11111 -111111' 11 (-111 h1111111''11111111' I -1111
Status:_ Reason:
009*001*******5-DIGIT 60615 BROOKS, FLORENCE 5306 S MARYLAND AVE CfflCAGO, IL 60615-4904
Claim Number: 1017018
Index Number: 2011313026 1002
Water Account Number: 300620135109
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Commiltee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return il lo your ward office before July 1, 2011.
_the undersigned, on oath,
depose and state that I am the applicant in the application, lhal this is my principal place of residence as of January 1, 2011. 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward: _
Intro. Date:
.III,!.!,.!!...!!!.!!.,,!!.!.!,,!.!.!!,,!,!,,,!!.!.!,!!!!!,,,,,
Status:_ Reason:.
019*001*********3-DIGIT 606 WEINBERG, SOLON J. 2044 E 72ND PL #3 CHICAGO, IL 60649-3004
Claim Number: 1020770
Index Number: 2025207049 1006
Water Account Number: 564296465296
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I So^W JT {l/jt2(~(J yyJ-Vf the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Cliairman
February 18, 2011
City of Chicago
11 - -111 h111' -11 -1 -111M1 -11111 -1111 - -1 -111 -1 -11111 -1 - r1 -1111
018*001*********3-DIGIT 606 BRENDEL, BONNIE A 5502 S HYDE PARK BLVD CHICAGO, IL 60637-1909
Index Number: 2013101222 1001
Telephone 312-744-3380
For Official Use Only: Ward:
Intro. Date:.
Status:_
Reason:_
Claim Number: 1021735
Water Account Number: 552478552478
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
the undersigned, on oath.
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011 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 of falsification herein.
OWNER SIGNATURE .^^^-^>^^^ DATE *D ~~ tt^j?*^ / /
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Chicago City Council - Committee on Finance
Page 1 of 1
MITT
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SEAP
Home > Claims > Sewer Charge Details >
Senior Citizens Annual Refund Application
Note: *AII Fields Must Be Filled In
Claimant Name
First
Claimant Address
Middle Initial
Last Name
Claimant City, State & Zip Code
City -
State IL
Zip Code
Claimant Telephone
Office
Home/7 7 3
Cellular.
Claimant Birthdate:
Must be 65 years of age, or older as of 3/10/2008
(/» 2l.C( ' V 0. dd/mm/yyyy format
Property Tax Number:
Example PIN Number (XX-XX-XXX-XXX-XXXX)
pin-i 3/0 "I io -12-2 -\(D£>(
If ~7 ^J^^xsx^rk^x-xxxx-xxx format
Water Account Number:
Building Type:
Cjk Condo
C Townhouse.
C Co-op Apartment
Signature information on Next Page ^^^^^c^t^S^,
'Click To Preview *;
Please print this and return application to your aldermanic office before July 1
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© 2008 Chicago City Council - Committee on Finance. All Rights Reserved ■ Use of this website signifies your agreement to the Terms.of Use.-> and Cirino Privacy Policy > Site Developed by Chicago Web Management
3/10/2008
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 201 1
For Official Use Only:
Ward:._
Intro. Date:_
||-['<Ill1!1!11!!-|-Il--Illll>l'"llllllll-lllll-I'l-'l-ll'1'1!'I
Status:_ Reason:.
019*001*********3-DIGIT 606 PASSMORE, HAYMON 6901 S OGLESBY AVE APT 9A CHICAGO, IL 60649-1827
Claim Number: 1019922
Index Number: 2024420001 0000
Water Account Number: 300810028202
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or lhat 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
ndersigned, on oath,
Please Print Name
DATE
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18,2011
For Official Use Only:
Ward:_
Intro. Date:_
,l,|,ll,,,,|l,l,,l,,,,ll|l,ll,,|,,,|ll,|l,|,||ll|l|l||l|l.
Status:, Reason
018*001*********3-DIGIT 606 WILLIAMS, SARAH 6640 S GREENWOOD AVE CHICAGO, IL 60637-4339
Claim Number: 1020971
Index Nu mber: 2023124019 0000
Water Account Number: 695391555433
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented lo the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, Ihe Committee on Finance must verify that you occupied this property.as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
Z^M^the undersigned, on oath.
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE.
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:-__
Intro. Date:_
IM -11 j 11111 - E' 1111111'1111 -11111 -11 - -1'' 111111111'' [' 1111' E11' 1
Status:_ Reason:.
018*001 *********3-DIGIT 606 HANSEN, ROBERT W. 1700 E56TH ST AFT 2703 CHICAGO, IL 60637-5092
Claim Number: 1018491
Index Number: 2013102029 1242
Water Account Number: 300820441559
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and dale this application and return it to your ward office before July 1, 2011.
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL I SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KJM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephune
Chairman mnv.c'dmmilteeonfinanee.rirg 312-744-3380
February 18, 201
1,1,,,,
liMO'l-lhliXii-'il'ii'l-l-ill11!1!1-^MIIiMMI-li
019*001 *********3-DTGiT 606 BRUMMrr, MARTHA J. 6935 S CRANDON AVE APT 8D CfflCAGO, IL 60649-1741
For Official Use Only: Ward:_■
Intro. Date:_
Status:_
Reason:_
Claim Number: 1018833
Index Number: 2024419018 1040
Water Account Number:"30081001^016---------
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
tfi(l\ (/"the undersigned, on oath,
Please Print Name
depose and stale that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that 1 have a legal or equitable interesi therein, that I am 65 years of age or older, and otherwise qualify for a refund under Section 3-12-050 ofthe Municipal Code ofthe 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 of falsification herein.
OWNER SIGNATURE__
V
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
Telephone 312-744-3380
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
,,l-ilihhl,lli,lTlll,i,iMII,iHlii'Hh"-Hilillill,i'
Status:_ Reason:.
009*001 *******5-DIGIT 60615 CONLEY, LESTER A. 1765 E 55TH ST APT E5 CHICAGO, IL 60615-5970
-Claim Numberrl018367'
Index Number 2013103011 0000
Water Accountdumber-300820439014
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05. . / ' ' : ' > ^ ,T !
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
; i- \e,y the undersigned, on oath,
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi 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 of falsification herein.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE.
DATE
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 201 1
For Official Use Only:
Ward:_
Intro. Date:_
■li'nl'-o'l-ii-l-lli-li'l-lll-illil'o-iiiMM'-hllll
Status:_ Reason:
018*001*********3-DIGIT 606
JOHNSON, HELEN
5532 S SHORE DR APT 14E
Claim Number: 1006397
CHICAGO, IL 60637-1990 Index Number: 2013103009 0000 Water Account Number: 300820427905
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhat you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it lo your ward office before July 1, 2011.
^\ £ O \T\ the undersigned, on oath,
depose and state that I am the applicanl in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that 1 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 of falsification herein.
Very Truly Yours. Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
OWNER SIGNATURE
AX 3^ / /
-<43*-22e
Alderman Edward M. Burke Chairman
City of Chicago
Wv' " 5530 S SHORE DR APT 13A
CHICAGO, II. 60637-1946
Index Number: 2013103009 0000
Telephone 312-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1018587
Water Account Number: 300820427905
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by. LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify lhat you occupied this property as your principal residence on ihe. first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
e undersigned, on oath,
Please Print Name^-
depose and slate that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or thai I have a legal or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund under Secdon 3-12-050 of the Municipal Code of the City of Chicago, that all water laxes, 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 of falsification herein.
OWNER SIGNATURE &J&z*-,\. ^jM^ DATE tf/o?c3.///
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
()()44i) ~^
11111.1>1111111! II11 (i1 ■ ■ 111 ■i■1■11.11111 1111" I ■ i >i1.11111■
018*001 *********3_DIGIT 606 AMAROSE, ANTHONY R 5532 S SHORE DR APT 21F CHICAGO. IL 60637-1999
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1017160
Index Number: 2013103009 0000
Water Account Number: 300820427905
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as.your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
MA R OSdjsC, undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, 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 1 understand I am subject to penalties for perjury of falsification herein.
OWNER SIGNATURI3^S&^ fi Q^rT^U*^ DATE /^l^A^*^, ^ ~>- ?C I
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:__
Intro. Date:_
'lllii-llli-l-lli-li"M-"illlrl'"i'lil'iill-illi-lllii
Status:_ Reason:
009*001*******5-DIGIT 60615 ROY, DAVID T. 5443 S CORNELL AVE # 3 CHICAGO, IL 60615-5778
Claim Number: 1019716
Index Number: 2012113051 1003
water Account Number: 539624539624
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1. 2011.
_the undersigned, on oath.
depose and slate lhat I am the applicant in the application, that this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate properly or that I have a legal or equitable interesi therein, that I am 65 years of age or older, and olherwise qualify for a refund under Section 3-12-050 of Ihe Municipal Code of the City of Chicago, lhal 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 of falsification herein.
Very Truly Yours, \J Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee, on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
Please Print Name
Alderman Edward M. Burke Chairman
February 18, 2011
004602
■-I'-i'lliiii'lilllll'i'ill-11!1111-!1
019*001******'***3-DIGIT 606 HARRIS, ADR1ENNE 6933 S CRANDON AVE APT 5C CHICAGO, IL 60649-2945
Index Number: 2024419018 1021
City of Chicago
I,!!!!!,!,,,,,,,,,!
Telephone 3.12-744-3380
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1003587
Water Account Number: 300810012009
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
I
IS
iu'Cfj S the undersigned, on oath,
Please Print Name
depose and state that I am the applicant in the application, that this is my principal place of residence as of January 1, 2011 that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, lhat 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 of falsification herein.
OWNER SIGNATURE fj^fiua^r
Atf-^ DATE
0
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf. RETAIN 1 COPY FOR YOUR RECORDS
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 201
IH,,,!!!!!.,!.!,,!.,.,,.!.!,,.!!,,,!,.!!!,,.!,.,!!!!!!!!.!.),.
009*001 *******5-DIGLT 60615 GUGLIOTTA, GLORIA G 1401 E55TH ST APT 502N CHICAGO, IL 60615-5476
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1023368
Index Number: 2014202076 1013
Water Account Nuinbeir552702552702
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Council by: LESLIE HAIRSTON of Ward 05.
To determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Senior Citizens Rebate Ordinance, the Committee on Finance must verify that you occupied this property as your principal residence on the first day of January, 2011. If the property meets these requirements, you must sign and date this application and return it to your ward office before July 1, 2011.
.the undersigned, on oath,
Please Print Name
depose and state lhal I am the applicant in the application, lhat this is my principal place of residence as of January 1, 2011, that I am the owner of record of said real estate property or that I have a legal or equitable interesi 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 of falsification herein.
OWNER SIGNATURE
DATE
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman LESLIE HAIRSTON Attn: KIM WEBER 2325 E. 71ST STREET Chicago, IL 60649
Please do not send it to the Comniittee on Finance; your alderman will introduce it on your behalf.
RETAIN 1 COPY FOR YOUR RECORDS