http://www.co.champaign.il.us/soaoff.htm CHAMPAIGN COUNTY ASSESSMENT OFFICE 1776 East Washington Street Urbana, Illinois 61802-4581 (217) 384-3760 • FAX (217) 384-3762 Monday-Friday 8:00 a.m.-4:30 p.m. APPLICATION FOR HOMESTEAD EXEMPTION LIMITED (35 ILCS 200/15-175) Real property owners in Illinois are allowed only one (1) General Homestead Exemption. This application must be signed by an owner of record or a person having a legal or equitable interest in this property. Please provide the following information: 1.) Your property’s Permanent Parcel Number (PIN): _________________________ 2.) Your date of occupancy: _________________ 3.) Your response to the following question: Are you the owner of record or do you have a legal or equitable interest in this property? _______________________ Print Name _____Yes _________________________ Signature _____No _______________ Telephone ________________________________ Address ________________________________ City State Zip Return to: Champaign County Assessment Office 1776 East Washington Street Urbana, IL 61802-4581 Office Use Only: 1977 AV ___________ Effective Year ___________ By ___________ American LegalNet, Inc. www.FormsWorkFlow.com