JOSEPH BERRIOS WWW.COOKCOUNTYASSESSOR.COM 2001122210 COOK COUNTY ASSESSOR'S OFFICE 118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE: 312.443.7550 FAX: 312.603.3352 COOK COUNTY ASSESSOR Incentives Appeal Town Appeal Year Property Index Number(s) Owner / Taxpayer Property Index Number(s) Owner's Mailing Address Property Street Address City Appeal Number City State Zip Zip State Daytime Phone Number Email Address Township Major Class The assessment on the property described above is inaccurate based on the following facts: Purchase Price Field Check Request Yes Purchase Date No Certificate of Error Request Estimate of Current Value Yes Class Change Request 6b 7a/b 8 9 Affordable Housing C L S SRO Open Space Farms Through my signature below, I affirm that I am the owner/lessee or appointed representative and that all the information is true to the best of my knowledge. Signature of Owner/Lessee or Representative Date As appointed representative for the owner/lessee of the property described above, I have also submitted the Owner/Lessee Verification Affidavit. Atty/Rep Code FOR OFFICE USE ONLY Received by (Assessor Staff) Date American LegalNet, Inc. www.FormsWorkFlow.com