Alderman Edward M. Burke Chairman
City of Chicago
Committee on Finance City Hall • Room 302 • 60602 www.commilteeonfinance.org
Telephone 312-744-3380
February 18, 2011
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016*001 *******5-DIGIT 60660 MILLER, WILLTAM 6101 N SHERIDAN RD CHICAGO, IL 60660-2870
Index Number: 1405211021 1021 Water Account Number: 300730523627 "
For Official Use Only: Ward:_
Intro. Date:_
Status:_
Reason:_
Claim Number: 1007983
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: MARY ANN SMITH of Ward 48.
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, 2€l 1.
I Aj,ll L-i Lu I A jOA l\\ ^Lfir^ndersigned, 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 falsificatiofi herein.
OWNER SIGNATURE
DATE
Very Truly Yours. Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman MARY ANN SMITH Attn: SANDY 5533 N. BROADWAY AVE Chicago, IL 60640
Please do not send it to the Committee on Finance; your ...
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