201 Appeal No: Total Sq. Ft. of Commercial/Industrial Area OccupiedTotal Sq. Ft. of Commercial/IndustrialArea VacantTotal Sq. Ft. of Area Total Number of Residential Occupied Total Number of Residential VacantTotal Number ofApartments JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberTotal(list all attempts made to lease vacant space)(002003004002005003006007btn013005fbnr016017005003020021022022(CITY)3.No attempts were made to lease the vacant space because:2.Attempts to lease the vacant space were made.(Please check all boxes that apply)Cook CountyAssessor's Officepersonal knowledge that the occupancy of the building(s) for the year is as follows:in, subject of the above complaint, and that I have}I, , being first duly sworn, on oath depose and say that I am theowner/managing agent of the property located at Total annual percent weighted vacancy of Residential condo/ apartmentsTotal annual percent weighted vacancy of Industrial/commercial space1.Photos of the vacant space are included with this appealVacancy/Occupancy Affidavit Condos or Apartments (Please circle)Commercial/IndustrialCondos/ApartmentsCondo/Apartments Residential Condo/ Include Commercial condos here.**** For vacancy appeals, the following information is needed: Three preceding years of actual historical income and expense information and a current year rent roll. American LegalNet, Inc. www.FormsWorkFlow.com 4. Since the space in question became vacant there has been approximately showings inquires offers 5. If offer(s) failed to result in leasing the vacant space, the reason(s) were: 6 . For the preceding and calendar years vacancy factors applied in excess of 15% by: 201 201 201 CCAO % % % BOR % % % BOTH % % % Reason(s) for requested vacancy relief for tax 201: Building Rehabilitation Conversion to Condominiums Re pair of Prior Tenant Damage New Construction Initial Start-Up Occupancy PreparationBuild-outFire, Flood, Natural Disaster Alteration, Modification or Conversion Construction or Completion Delay to New Use Building Code Compliance Governmental or Court Order Closure Notice or Red Tag Structural, Mechanical, Electrical Zoning Plans and Permits Hearin / ReviewApproval or OrdinanceFinancing Final Inspection / Occupancy Further affiant sayeth not.Subscribed and sworn before me,thisday of , 20AffiantNotary Public [Notary Seal or Stamp] Other: American LegalNet, Inc. www.FormsWorkFlow.com