City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall • Room 302 • 60002 Telephone
Chairman www.conimilteeonfinance.or
" 312-744-3380
February 18, 201 I
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017*003*********3-DIGIT 606 CUNNINGHAM, FRANCES A. 2051 W AINSLIE ST#1W CHICAGO, IL 60625-1333
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1021118
Index Number: 1407324043 1007
Water Account Number: 448654448654
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: EUGENE C. SCHULTER of Ward 47.
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 PLANUS tX .(jyv"') iv^ix^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 ofJanuary 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 jlixes, property taxeSydfld all oiher fees, penalties or assessments owed to the City of Chicago have been paid and that I und:rsland I am subjec/to/penal/ies for perjury of falsification herein.
OWNER SIGN ATUR^T/^^t Very Truly Yours.
DATE
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman EUGENE C. SCHULTER
Attn: SHELIA
121 N. LA SALLE ST
ROOM 300
Chicago, IL 60602
Please do not ...
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