Vacancy/occupancy Affidavit Form
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1Cook County
Vacancy/Occupancy Affidavit
Assessor's Office
_____________________
_
2016 Appeal No:
}
I, ______________________________________________, being first duly sworn, on oath depose and say that I am the
owner/managing agent of the property located at __________________________________________________________
(3523(57< ,1'(; 180%(5 6
in__________________________________________________________, subject of the above complaint, and that I have
(CITY)
personal knowledge that the occupancy of the building(s) for the year ______________is as follows:
Condos or Apartments
(Please circle)
Total Sq. Ft. of
Total Sq. Ft. of
Total Sq. Ft. of
Total Number of Residential
Total Number of Residential
Total Number of
Commercial/Industrial
Commercial/Industrial
Condos/Apartments
Commercial/Industrial
Condo/Apartments
Residential Condo/
*
Area Occupied
Area
*
*
Vacant
Occupied
Apartments
Area Vacant
January
February
March
April
May
June
July
August
September
October
November
December
Total
Total annual percent
Total annual percent
weighted vacancy of
weighted vacancy of
Residential condo/
Industrial/commercial space
apartments
*
Include Commercial condos here.
(Please check all boxes that apply)
1.
Photos of the vacant space are included with this appeal
2.
Attempts to lease the vacant space were made.____________________________________________________ _
(list all attempts made to lease vacant space)
__________________________________________________________________________________________ _
__________________________________________________________________________________________ _
3.
No attempts were made to lease the vacant space because:__________________________________________ _
__________________________________________________________________________________________ _
For vacancy appeals, the following information is needed: Three preceding years of
actual historical income and expense information and a current year rent roll.
Subscribed and sworn before
me,
this_______day of __________________, 20_____
Further affiant sayeth not.
Notary Public
Affiant
[Notary Seal or Stamp]
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