Ptax-762-C Form - Certificate Of Ineligibility For Model Home Assessment - Madison Ccao
Download a blank fillable Ptax-762-C Form - Certificate Of Ineligibility For Model Home Assessment - Madison Ccao in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Ptax-762-C Form - Certificate Of Ineligibility For Model Home Assessment - Madison Ccao with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.
PTAX-762-C
Certificate of Ineligibility for Model Home Assessment
Who must complete this form?
When and where must I file?
You must complete this form and specify the reason for ineligibility
You must file this form with the chief county assessment officer
when any portion of the model home property no longer qualifies for
(CCAO) at the address shown below within 60 days of the date the
the alternate assessment. (See Question 4, Step 1)
property becomes ineligible.
Note: You may be required to provide additional documentation.
Step 1: Complete the following information
1
4 Check the reason for ineligibility
Property owner’s name
occupied as a dwelling
_________________________________________________
sold for use other than as a model home
Street address of model home property
_____________________________IL __________________
leased for use other than as a model home
City
ZIP
more than 3 model homes located at the same time within
(_______)_________________________________________
a 3-mile radius
Daytime phone
other (specify)__________________________________
Send notice to (if different than above)
5
Write the property index number (PIN) of the property for which
2
you received the model home assessment. Your PIN is listed on
Name
your property tax bill or you may obtain it from the CCAO. If you
are unable to obtain your PIN, write the legal description on
Mailing address
Line b.
_________________________________________________
a PIN___________________________________
City
State
ZIP
b Write the legal description only if you are unable to obtain
(_______)_________________________________________
Daytime phone
your PIN. (attach separate sheet if needed)
_______________________________________________
3
Write the date the property became ineligible for the model
_______________________________________________
home assessment.
/
/
_______________________________________________
Step 2: Sign below
Under penalties of perjury, I state that, to the best of my knowledge, the
Subscribed and sworn to before me this
day
information on this form is true, correct, and complete.
of
,
.
/
/
_________________________________________/____/______
Property owner’s or authorized representative’s signature
Date
Notary public
Date
If you have any questions, please call:
Mail your completed Form PTAX-762-C to:
(_618_)__692-6270_________________
MADISON
County Chief County Assessment Officer
157 N MAIN ST, SUITE 229______________________________
Mailing address
Edwardsville___________________________ IL ____62025____
City
ZIP
For use by the CCAO
Date received
/
/
Comments
_______
PTAX-762-C (N-09/03)
Reset
Print
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Cdphe-imm Ci-c Rc Certificate Of Immunization For College/university Students - Colorado Department Of Public Health & Environment
Legal
Form Soc 2285 - In-home Supportive Services Program Notice To Recipient Upholding Provider's Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits
Legal
Related Categories
Parent category: Financial