Form Ptab-1-A - Residential Appeal
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4RESIDENTIAL 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
TTY (217) 785-4427
TTY (847) 294-4371
Failure to properly complete this form and provide the necessary documentation shall result in 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 the 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.
ection II
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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.
2a Property ID No. (P .I.N.)_____________________________ Township : ________________________________________
Address of property: ______________________________________________________________________________
(Cook County) Property Class No._______________________________________ Volume No.____________________________
2b If appellant is other than owner, give name and address of owner: Owner _______________________________________
Address_______________________________________________________________________________________
street
city
state
ZIP code
2c The assessments of the property for the year as made by the (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________________
Lines 1 through 3 above must be completed. This information is available from the supervisor of assessments/county assessor
or the board of review offices.
The Property Tax Appeal Board will decide the appeal based on the evidence submitted by the parties unless it determines
a hearing is necessary or any party requests a hearing in writing.
_____ I request an oral hearing. (Check for a hearing.)
2d
Date: ____________________
Signature: _________________________________________
Attorney or Appellant only
PTAB-1-A (R-7/02)
IL-492-3400
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