Form Ptab-11-A - Industrial Appeal printable pdf download

Docket No.___________________________

(Office Use Only)

INDUSTRIAL APPEAL

State of Illinois - Property Tax Appeal Board

Room 402 Stratton Office Building

Suburban North Regional Office Facility

401 South Spring Street

9511 West Harrison Street, Suite 171

Springfield, IL 62706-4001

Des Plaines, IL 60016-1563

(217) 782-6076

(847) 294-4360

TDD (217) 785-4427

TDD (847) 294-4371

Failure to properly complete this form and provide the necessary documentation shall result in the dismissal of your appeal.

For Assessment Year 20______

Are you appealing off a recently issued township equalization factor? (Multiplier)

yes

no (Not applicable to Cook County.)

If an appeal was filed with the Property Tax Appeal Board on this Tax Parcel for the prior year, please indicate the Property Tax Appeal Board docket number

assigned to that appeal:____________________________________________________

Section I

This form must be completed and filed within 30 days of the postmark on the decision you received from the Board of Review. Any additional written evidence

must be submitted with this PTAB form. If you are unable to submit the additional written information with this form, a letter requesting an extension of time for

filing the additional evidence must be submitted with this form. Without a written request for an extension, no evidence will be accepted after the 30 days. The

Property Tax Appeal Board will grant only reasonable requests up to 90 days. Faxed copies of this form will not be accepted.

WHERE TO FILE THIS APPEAL:

If your property is located OUTSIDE of Cook County, file your appeal and all related documentation with the SPRINGFIELD office. If your property is

located IN Cook County, file your appeal and all related documentation with the DES PLAINES office. The addresses are listed above. Without prior

Property Tax Appeal Board approval, a separate appeal must be filed on each individual Property Identification Number (P .I.N.), or a breakdown may be

submitted (see 2c below.).

This form must be submitted in triplicate.

Evidence must be submitted in duplicate where a change in assessed valuation of less than $100,000 is sought.

Evidence must be submitted in triplicate where a change in assessed valuation of $100,000 or more is sought.

Section II

Appellant ___________________________________________

Attorney for Appellant ___________________________________

Street ______________________________________________

Street ________________________________________________

City _______________________________________________

City __________________________________________________

State, Zip ___________________________________________

State, Zip ______________________________________________

Telephone __________________________________________

Telephone _____________________________________________

Petition is hereby made to appeal from the final, written decision of the ______________________________________ County Board of Review relating to the

property described below. Notice of such decision was postmarked on ____________________________________________________________________

Submit 2 copies of the Notice of Final Decision on Assessed Value by the Board of Review.

Property ID No. (P .I.N.) _______________________________________ Township ____________________________________

Address of Property _____________________________________________________________________________________

(

Property Class No. ____________________________

Volume No. __________________________________

Cook County)

If the appellant is not the owner, give name and address of the property owner: Owner _________________________________

Address_____________________________________________________________________________________________

street

city

state

ZIP code

The assessments of the property for the year as made by the (1 P .I.N. only): A separate page may be attached for multiple parcels.

1. Assessor

Land _________________

Impr. _________________

Total ___________________

2. Board of Review

Land _________________

Impr. _________________

Total ___________________

3. Appellant’s claim

Land _________________

Impr. _________________

Total ___________________

NOTE: Lines 1 through 3 must be completed. This information is available from the Supervisor of Assessments, County Assessor or the Board of Review offices.

May the Property Tax Appeal Board decide the appeal based on the evidence submitted by the parties without an oral hearing?

______ Yes

______No, I request an oral hearing.

Date __________________________

Signature_______________________________________________________

Attorney or Appellant only

PTAB-11-A (N-10/00)

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