Form 4817 - Residential Assessed Valuation Appeal

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RESIDENTIAL ASSESSED VALUATION APPEAL
Cook County Assessor’s Office
APPEAL YEAR
APPEAL NUMBER
James M. Houlihan
118 North Clark Street Chicago, IL 60602
Phone: 312.443.7550 Website:
Cook County Assessor
TYPE OR PRINT ALL INFORMATION
NAME OF OWNER/LESSEE
PHONE (daytime)
OWNER/LESSEE ADDRESS
CITY & ZIP CODE
PROPERTY ADDRESS
CITY & ZIP CODE
TOWNSHIP
PROPERTY INDEX NUMBER (PIN)
IF MULTI-PARCEL APPEAL, INDICATE ADDITIONAL NUMBER(S) HERE:
IF YOU WISH ONLY TO CHANGE YOUR PROPERTY CHARACTERISTICS, COMPLETE THE REVERSE SIDE OF THIS FORM & SIGN BELOW
1.
CHECK THIS BOX IF YOU WISH TO FILE AN APPEAL AND COMPLETE THE FOLLOWING STEPS:
2.
CHECK APPROPRIATE REASON(S) FOR APPEAL
3. COMPARABLE PROPERTIES (optional)
Lack of Uniformity
Other
Overvaluation
Property Description Error
(Update Property Characteristics
On Reverse Side of Form)
Through my signature below, I affirm that I am the owner/lessee or appointed representative and that all information is true and accurate to the best of my knowledge.
Signature of Owner/Lessee or Representative
Date
Received by (Assessor Staff)
Date
As appointed representative for the owner/lessee of the property described above, I affirm: (1) that I have read the Cook County Assessor’s Rules for Filing Appeals; and (2) that I have knowledge of
the matters covered in this appeal.
FOR OFFICE USE ONLY
Name (Please Print)
Phone Number
Representative
REASON CODE
AV
Code
Address
City
Zip Code
Form 4817 Rev. 2000

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