City of Chicago
Alderman Edward M. Burke Chairman
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
f"! ■11 (■ I (11f 11! 11' ■"f 1"" t""'" I" 11f 11' I" 111" 11"1" 1111" 11 i 11" 11"
Status:_ Reason:.
016*001*******5-DIGIT 60660 OROZCO, NANCY E. 6301 N SHERIDAN RD APT 8K CHICAGO, IL 60660-1719
Claim Number: 1017172
Index Number: 1405203011 5462
Water Account Number: 300730550277
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: JOE MOORE of Ward 49.
To determine whether your condo/co-op/townhouse qualities 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 ofJanuary, 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 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 JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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
City of Chicago
Committee on Finance
Alderman Edward M. Burke Cily Hall Room 302 60602 Telephone
February 18, 2011
Ii'x-'t'IiI'I'I-IIII-'i-'iIIiOi-'i'I'-Ii-'I'i-I'-ii-NN
017*003*********3-DIGIT 606 RICHMAN, GERALD 1444 W JARVIS AVE APT IC CHICAGO, IL 60626-2063
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1021306
Index Number: 1129311026 1003
Waler Account Number: 444034444034
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: JOE MOORE of Ward 49.
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 ofJanuary, 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.
Please Print Name
depose and state 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 taxes, property taxes, anckSll other fees, penalties or assessments owed to the City of Chicago have been paid and that I understand I am subject wpenalties for perjury of falsification herein.
OWNER SIGNATU
Very Truly You
CL
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago. IL 60626
Please do not send it to the Committee on Finance: your alderman will introduce it on your behalf.
RETAIN I COPY FOR YOUR RECORDS
' City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Telephone
February 18, 2011
HiIH-IiIt'i'ii.....I'-IHil"!!1'11'"'^^'!!!''!!'!!!!
016*001*******5-DIGIT 60660 CONDON, RICHARD F. 6334 N SHERIDAN RD APT 6E CHICAGO, IL 60660-1754
For Official Use Only: Ward:_
Intro. Date:.
Status:_
Reason:_
Claim Number: 1021229
Index Number: 1405202018 1020
Water Account Number: 452180452180
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: JOE MOORE of Ward 49.
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.
I RKHARp h Cdr\lpof\i 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 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 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 f^A&AJL ^. ^^■W DATE CLA^j^ I > % O 7 1
Very Truly Yours, ;
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
Please do not send it to the Committee on Finance; your alderman will introduce it on your behalf.
RETAIN I 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:_
hillilinilil-l-ilrli"lrl'Ml"lllll'il"lil.....'Ill'l-1
Status:_ Reason:.
017*003*********3-DIGIT 606 AHMAD, S. NASEEM 1524 W FARWELL AVE APT 2E CHICAGO, IL 60626-3647
Claim Number: 1019433
Index Number: 1132115021 1008
Water Account Number: 429812429812
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: JOE MOORE of Ward 49.
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 lhat you occupied this property 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 1, 2011.
depose and state 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 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.
Very Truly Yours, Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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 S-N/\5£Firt A/'-trlAP the undersigned, on oath,
Please Print Name
DATE
228
Alderman Edward M. Burke Chairman
City of Chicago
February 18, 2011
1111[ 1111111111111 -1 -111 -11 - -1111111 -1111 -11 < i1 - -1 -111 -11!
017*003*********3-DIGIT 606 TRILLING, CAREN 1313 W PRATT BLVD CHICAGO, IL 60626-5277
Index Number: 1132304030 1004 Water Account Number: 445232445232
Telephone 312-744-3380
For Official Use Only: Ward: _;
Intro. Date:_
Status:_
Reason:_
Claim Number: 1023257
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: JOE MOORE of Ward 49.
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 properly as your principal residence on the first day ofJanuary, 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,
Please Print Name /
depose and state 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 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 fi
OWNER SIGNATURE
perjury of falsification herein.
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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, 201 1
For Official Use Only:
Ward:_
Intro. Date:_
||,|l||l|T,|||l.||ll||.|||lrl.l.|.|,|l||.||l|,,.l|||.||l||l
Status:_ Reason:.
016*001*******5-DIGIT 60660 GU.WENXIA DU.GUOGUANG 6301 N SHERIDAN RD APT 14R CHICAGO, IL 60660-1779
Claim Number: 1022502
Index Number: 1405203011 1189
Water Account Number: 300730550277
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: JOE MOORE of Ward 49.
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 ofJanuary, 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 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 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 JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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
OWNER SIGNATURE [Q.(2^^Cl~^
Alderman Edward M. Burke Chairman
City of Chicago
312-744-3380
Telephone
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
Status:_ Reason:.
013*001 *******5-DIGIT 60645 MACDONALD, NORMAN M. 7200 N RIDGE BLVD APT 4E CHICAGO, IL 60645-2073
Claim Number: 1022261
Index Number: 1130322038 1033
Water Account Number: 444639444639
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: JOE MOORE of Ward 49.
To determine whether your condo/co-op/townhouse qualities 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 ofJanuary, 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 lo 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 JOE MOORE Attn: WAYNE FRAZER 7356 N. GREEN VIEW AVE , Chicago, IL 60626 1
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 NoC^HMi M.M/lcI^Or^ftLfrhe undersigned, on oath,
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:_
'il'h'r'ul'11-Mr'I'M^'ir-ll-iiiM11!1!1'1 ImI'1 M'-lll-'l
Status:_ Reason:.
016*001*******5-DIGIT 60660 VUJOSEVICH, VERA 6301 N SHERIDAN RD APT UK CHICAGO, IL 60660-1776
Claim Number: 1017456
Index Number: 1405203011 1149
Water Account Number: 300730550277
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: JOE MOORE of Ward 49.
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 ofJanuary, 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, lhat this is my principal place of residence as ofJanuary 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.
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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
e.5*«3*.228
Chicago City Council - Comniittee on Finance - Application for Senior Citizens Sewer C... Page 1 of
City of Chicago Claim Form
Application For Senior Citizens Sewer Charge Annual Refund
Fill in the fields below and print form. Sign and take this to your alderman's office.
FOR OFFICIAL USE ONLY
CLAIM*,
WARD_
DATE
STATUS
R_
Note: *AII Fields Must Be Filled In
Claimant Name
Kenneth S Tenny
Claimant Address
6300 N. Sheridan Rd.- Apt.#712
Claimant
City, State & Zip Code
Chicago , IL 60660-1746
Claimant Telephone
Office
Home
773-338-6158
Cellular
Claimant Birthdate:
27/09/1935
Property Tax Number:
PIN 14- 05- 202- 019- 1105
Water Account Number:
45-21-74-452-174
Building Type:
Condo
Com Units
Res Units 125 - '
11
I,____;_(print your name), the undersigned on
oath deposes and states that I am the applicant on this application, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund under Section 3-12-050 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 or falsification'Jiierein.
// j/L OWNER SIGNATURE: afg^^jf^^^^j A g/yt/f/
DATE:
ilf v;EditSFo^i! :Pri'nt4this-ciaim fwmuMh
Please print this and return application to your aldermanic office before July 1
© 2007 Chicago City Council - Committee on Finanace. All Rights Reserved
2/1/2011
Jan. 28. 201 1 1 2:04
No. 5761 P. 2
CHy of Chicago
Department of Revenue-Water Division P.O. Box 6330 Chicago, Illinois 60680-6330
NOV 1 5 2010
METERED ACCOUNT
Little leaks cause big bills.
Check for and repair leaks.
You must pay for all metered water.
PAY ONLINE: Pay your bill online from the convenience of your home or office: http:/Mww.cltyofcrucago.org/revenue
CUSTOMER NAME
■ACCOUNT NUMBER
BILL DATE
DUE DATE
Attn: 6300 SHERIDAN ROAD CONDO 452174-452174 Nov-10-2010 Dec-01-2010
ASSOC
Service Address: 6300 26 N SHERIDAN RD CHICAGO IL 60660
Summary of Charges for Sep-02-2010 thru Nov-01-2010
Total Current Water.................................................................................. $ 2943.66
Total Current Sewer.................................................................................. $ 2531.55
Penalty.................................................................................................... $ 000
Total Current Charges............................................................................ $ 5475.21
Previous Balance....................................................................................... $ 5553.53
Adjustments............................................................................................ $ 000
Payments................................................................................................... $ 5553.53
Total Due................................................................................................ $ 5476.21
Penalties accrue al a rate ol 1.25% per monlh on late balances.
The Department al Ravmut's Waler Division altars a vertely ol flexible payment plana for water bills Including a specl*) clrcumBtancafiftiafdstUp plait for those *ho quality. Avoid Water shut off or have yo ur Mtvfce reetored by entering a plan. Vlsll ub on-line or ci» ub for mora intoimallon.
Meter Reading Details
METERED UNITS READINGS
IN THOUSANDS -PREVIClUS j; CURRENT
1000 Cubic Feel = 7480 Gallons
USAGE IN THOUSANDS Cubic Feet. =: ,: Gallons.,
ACTUAL nr tSTIMATED
Gallons
18055
19523
196.2
1466
12012010 0004521740452174 A 0000547521 0000547S51 B
PAY ONLY THIS AMOUNT
$ 45.43
/ BY 12/13/10 (on time)
2009 Second Installment Property Tax Bill
Properly Index Number (PIN) Volume Code Tax Year (Payable In) Township
14-05-202-019-1105 472 73001 2009 (2010) LAKE VIEW
IF PAID LATE 12/14/10 $
- 01/13/11
46.11
IF PAID LATE 01/14/11 - 02/13/11
$ 46.79
IF PAID LATE 02/14/11 - 03/13/11
$ 47.47
THANK YOU FOR YOUR FIRST INSTALLMENT PAYMENT OF:
t. ,'., , i -,, Property location and classification for this PIN CHICAGO IL 60660 1750
LATE PENALTY IS 1.5% PER MONTH, BY STATE LAW.
6300 N SHERIDAN RD
Taxing District
2009 Tax 2009 Rate 2009 %
Pension
MISCELLANEOUS TAXES
Metro Water Reclamation District Parks-Museum/Aquarium Bond Chicago Park District Miscellaneous Taxes Total
7. 74 0. 42
8. 75 16. 91
261 014 295 570
5. 647. 0. 317.
6. 387. 12. 33%
0. 44 0. 35
8. 73 0. 52 10. 68 19. 93
252 015 308 575
SCHOOL TAXES
Board of Education Chicago Cornmuiiiiy College Oisi 508 School Taxes Total
70. 18 ' 4. 45 74. 63
2. 366
150 516
51.
3. 54.
147. 2i >. 38%
85. 68
5. 4I~ 91. 09
472 i 56 628
MUNICIPALITY/TOWNSHIP TAXES
Chicago School Bldg & Imp Fund Chicago Library Fund City of Chicago Munlclpallty/Townshlp Taxes Total
3 2 26 32
32 94 31 57
112 099 887 098
2. 427.
2. 147. 19. 177. 23.73%
12. 10
4.
3. 32. 39.
06 54 16 76
117 102 928 147
COOK COUNTY TAXES
Cook County Forest Preserve District County of Cook Cook County Public Safety Cook County Health Facilities Cook County Taxes Total
45 81 38 49 13
0. 049 0. 196 0. 114 0. 084 0. 443
1. 067. 4. 237.
2. 467. 1. 817. 9. 56%
02 10
1. 77 7. 75 3. 64
2. 98 16. 14
0. 051 0. 224 O. 105 0. 086 0. 466
(Do not pay these totals)
137. 24
4.627 100.00%
166.92
4. 816
KENNETH S TENNY 6300 N SHERIDAN #712 CHICAGO IL 60660-1746
'■ -v vy.co If1'--' r- ' Property Classification 2-99
2008 Tax 2008 Rate
TAX CALCULATOR
' ■ / '{■,■'■ SVT.'S Mf-SR$i~Jf
' 2008 Assessed .Value'iWSj'W?
■ '■■.;■■■*:'■■'< ■■vif,w-¥*'2.-?jj--
S'2009;Property yalueVK>*;$^£f: "- ■ ,V.'l 147770
2009 Assessment.Level
10%
2009 Assessed Valued
i=1?$77
-' ' 2009 State.Equalizatibn' Factof;.?1^;
.'X';;; ''". . .; 3'.:3701
-v2009 Equalized Assessed !VaW(EAV) l 7?2uraiLocal«Tax Rairy^l^^i
It I
,'.679 4: 627%
'2009 Total/Tax Before'Exemptions.-;
S\K j^jb^sb' .
' >^£iXfc.-: ■ Homeowner's Exemptioni-*v«c,H'-' . ;',■<. 7fri,\-<i&277!:&2 .
■' Senior.Citizen Exemption'i'-^'.'WvV-' ,Senior Assessment. Freeze'Exemption '
V,:.189^74.
''. 2009 Total :.Tax After ExemptipnsVC'1' ff
'M37/24
r.ir..li:-.J'^fl
: First'lnstallment;
: Second Installment'/ y&h&Xs&i' ■ +/;.! ■*,#,',^.~-»!45.'43
< Total 2009 Tax (Payable In 2010). :'
." . .-'. = .*V- h:137 24
'tQfl' &:;:■■'
Ft
a-
Km;.; ■Sir
H:> [Of:
O.:
jet
at
m w
£*&-'■'
IF YOUR TAXES ARE PAID BY MORTGAGE ESCROW, BE SURE NOT TO DOUBLE' PAY.]^i^h.j^^^^s;
/tenon
Jesse White - Secretary of State
NUMBER ISSUED _ EXPIRES
T500-5173-5275 09-04-03
09-27*17
KENNETH STENNY
6300 N SHERIDAN. APT.712
CHICAGO IL 60690
Birthdate 09-27-35
Male 5'09" 140 lbs BRN Eyes
Restrictions ;^ype'.-"Class
; '- ; org" d ,;
drivers;
LICENSE-"
City of Chicago
Committee on Finance
Alderman Edward M. Burke City Hall Room 302 60602 Teleplione
February 18, 2011
'1111 -'' 111 h 111 * 11 -11 -1 -'111111111 i111111' 11 ] 11
016*001*******5-DIGIT 60660 GOLDBERG, MITZI 6300 N SHERIDAN RD APT 503 CHICAGO, IL 60660-1741
lll'I'l
For Official Use Only: Ward:_'
Intro. Date:_
Status:_
Reason:_
Claim Number: 1020289
Index Number: 1405202019 1064
Water Account Number: 452174452174
2011 SENIOR CITIZENS SEWER REFUND RENEWAL
Dear Senior Citizen:
Your 2011 application lor the Senior Citizen's Sewer Rebate was presented to the City Council by: JOE MOORE of Ward 49.
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 ofJanuary, 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,
Please Print Name
depose and state 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, 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 lo the Cily of Chicago have been paid and that I understand I' am subject to jaSnalties for perjury of falsification herein.
OWNER SIGNATURE^'^V' ./ W t^/fa^^-fl DATE_
Very Truly Yours,
Edward M. Burke
MAIL 1 SIGNED AND DATED COPY DIRECTLY TO YOUR WARD OFFICE AT:
Alderman JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
Please do not send it to the Conimittee 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
Teleplione
February 18, 2011
For Official Use Only:
Ward:_
Intro. Date:_
i|llll|i|hllH||iMrM|Tin|||l|M|i|iHriu|i||in||
Status:_ Reason:.
0I7*003*********3-DIGIT606 SHIMIZU, MIDORI 1626 W GREENLEAF AVE CHICAGO, IL 60626-2760
Claim Number: 1021425
Index Number: 1131208030 1010
Water Account Number: 445873445873
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: JOE MOORE of Ward 49.
To determine whemer 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 ofJanuary, 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 ofJanuary 1, 2011, thai I am the owner of record of said real estate property or that I have a legal or equitable inlerest 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 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 JOE MOORE Attn: WAYNE FRAZER 7356 N. GREENVIEW AVE Chicago, IL 60626
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
0