Alderman Edward M. Burke Chairman
February 18.2011
City of Chicago
Committee on Finance City; Hall • Room 302 • 60602 vwiv.committeeonlinance.ofji
For Official Use Only: Ward:. Intro. Status:_ Reason:.
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0l8*OOl+********3-DIGIT 606 KOSINSKA, DANUTA 6407 S OAK PARK AVE #B-21 CHICAGO, IL 60638-4842
Index Number: 1919208050 1012 Wafer Account Number: 550065550065
2011 SENIOR CITIZENS SEWER REFUND RENEWAL Dear Senior Citizen:
Your 2011 application for the Senior Citizen's Sewer Rebate was presented to the City Coiincil by: MICHAEL R. ZALEWSKI of Ward 23.
lb determine whether your condo/co-op/townhouse qualifies for a $50.00 rebate under the Ordinance, the Committee on Finance must verity that you occupied this property as day of January, 2011. If the property meets these requirements, you must sign and date your ward office before July 1. 2011.
.the undersigned, on oath,
Please Print Name
depose end state that I am the applicant in the application, that this is my principal place that I am the owner of record of said real estate property or that I have a legal or equitable years of age or older, and otherwise qualify for e. refund under Section 3-12-050 of the Mi Chicago, that all water taxes, property taxes, and all other fees, penalties or assessments been paid and that I understand I am subject to penalties for perjury of falsification herein
OWNER SIGNATURE. Very Truly %urs, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman MICHAEL R. ZALEWSKI 'Attn: MAROE 6247 S. ARCHER AVB Chicago. IL 60638
Please do not send it to the Commute on Finance; your alderman will introduce it on yoifr behalf. RETAIN 1 COPY FOR YOUR RECORDS
Telephone 312-744-3380
Claim Number: 1016048
Senior Citizens Rebate your [principal residence on the first this application and return il to
of
residence as of January 1, 2011, interest therein, that I am 65 nicipal Code of the City of ojved to the...
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