Tax Year 2017 Real Estate Assessed Valuation Appeal Form - Cook County Assessor Joseph Berrios
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1
2Cook County Assessor's Office
Joseph Berrios
RESIDENTIAL
COOK COUNTY ASSESSOR APPEAL NUMBER
R
118 N. Clark Street - 3rd Floor
Cook County Assessor
Chicago, Illinois 60602
Tax Year 2017 Real Estate Assessed Valuation Appeal
Hours: 8:30 A.M.- 5:00 P.M.
RECEIVED AND CHECKED BY:
List in ascending order all Permanent Index Numbers
PLEASE COMPLETE ALL PARTS OF THE APPEAL FORM. TYPE OR PRINT ALL INFORMATION. COMPLY WITH ASSESSORS OFFICE RULES AND
REGULATIONS IN FILLING OUT AND FILING THIS FORM
associated with the subject property.
IF AIR RIGHTS PROPERTY, SUBMIT PLAT OF SURVEY.
CERTIFICATE OF ERROR
SUBJECT PROPERTY PERMANENT
IDENTIFICATION AND STATUS OF OWNER / TAXPAYER
YEAR(S)
INDEX NUMBER(S) [PINS]
2016
2015
2014
Name of Taxpayer / Owner
1
Address
Email
2
1
City
State
Zip Code
Phone
3
4
Owner
Former Owner Liable for Tax
Tenant Liable for Tax
Executor
Beneficiary of Trust
5
Select one:
Other (Explain)
6
NATURE OF APPEAL - LOCATION AND IDENTIFICATION OF REAL ESTATE
LIST COMPARABLE PROPERTY PINS
BELOW
Appeal Type:
Current Year Appeal Only
Current Year & C of E
C of E Only
Taxable
Exempt
Street Address
1
Location of Subject
City
Township
2
Property:
3
2
DATA SUBMITTED WITH APPEAL
DATA TO BE SUBMITTED
4
5
How is the Subject Property
6 Apartments or Less
Mixed Use
Single Family
used? Check all that apply.
Check appropriate reason(s) for appeal:
Other (Explain)
Lack of Uniformity
Overvaluation
If purchased on or after January 1, 2014, indicate year purchased and purchase price. If purchased prior to January 1, 2014 insert "prior".
Vacancy/Occupancy
Fire Damage
Purchase Price
Year
Property Description Error
Building is
Uninhabitable
The undersigned states that he/she has read this appeal, has personal knowledge of the contents thereof, and the same is true in substance and in fact and further so certifies
Building no longer exists
under the penalties as provided by law pursuant to section 1-109 of the Illinois Code of Civil Procedure. NOTE: FAILURE TO FILE OWNER / LESSEE AFFIDAVIT MAY
Other (if other, you must provide a narrative
RESULT IN DENIAL OF THIS APPEAL.
using the appeal narrative form)
Signature of Taxpayer or Attorney / Representative
ATTORNEY / REPRESENTATIVE ONLY
ATTORNEY/REPRESENTATIVE CERTIFICATION: I
ATTORNEY / REPRESENTATIVE NAME (PRINT OR TYPE)
FIRM / COMPANY NAME
certify that I have obtained from
3
FIRM / COMPANY ADDRESS
CITY
ZIP
PHONE
TAXPAYER NAME
(1) explicit authorization to file this 2017 assessment appeal and/or Certificate of Error and
(2) the Taxpayers assurance that I am the only attorney
TAXPAYER TITLE OR POSITION
Representative so authorized.
Attorney / Representative Fax Number
Attorney / Representative Signature and Code Number
e-mail Address
NOTICE TO FILERS:
YOU WILL BE NOTIFIED BY MAIL OF THE APPEAL NUMBER. YOU CAN FIND YOUR APPEAL NUMBER AND CHECK APPEAL STATUS ONLINE @
THIS FORM MUST BE PRESENTED IN DUPLICATE. FILE 1ST COPY WITH COOK COUNTY ASSESSOR'S OFFICE - RETAIN TIME STAMPED 2ND COPY FOR YOUR RECORDS.
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