JOSEPH BERRIOS WWW.COOKCOUNTYASSESSOR.COM Industrial / Commercial / Apartment Appeal 2011 Appeal Year Owner / Taxpayer Appeal Number Property Index Number Owner's Mailing Address Town Property Index Number(s) City State Zip Property Index Number(s) Daytime Phone Number Property Index Number(s) Property Street Address Property Index Number(s) City State Zip Township Major Class Field Check Request Yes Property Index Number(s) Property Index Number(s) Purchase Price Purchase Date Additional PINs are listed on the back of this page. The assessment on the property described is inaccurate based on the following facts: No Estimate of Current Value Certificate of Error Request Yes 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 Representative's Name/Firm Name (if applicable) Atty/Rep Code Representative's Street Address (if applicable) Daytime Phone Number City State Zip 4901122210 COOK COUNTY ASSESSOR'S OFFICE 118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE: 312.443.7550 FAX: 312.603.3352 COOK COUNTY ASSESSOR As appointed representative for the owner/lessee of the property described above, I have also submitted the Owner/Lessee Verification Affidavit. American LegalNet, Inc. www.FormsWorkFlow.com JOSEPH BERRIOS COOK COUNTY ASSESSOR'S OFFICE 118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE: 312.443.7550 FAX: 312.603.3352 WWW.COOKCOUNTYASSESSOR.COM Industrial / Commercial / Apartment Appeal Additional Property Index Numbers Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) Property Index Number(s) American LegalNet, Inc. www.FormsWorkFlow.com 4902122210 COOK COUNTY ASSESSOR