JOSEPH BERRIOS WWW.COOKCOUNTYASSESSOR.COM 0401122210 COOK COUNTY ASSESSOR'S OFFICE 118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE: 312.443.7550 FAX: 312.603.3352 COOK COUNTY ASSESSOR Vacant Land 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 Township Email Address Major Class Comparable Properties (optional) Purchase Price Field Check Request Yes The assessment on the property described above is inaccurate based on the following facts: Purchase Date No Certificate of Error Request Yes Estimate of Current Value 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 Reason Code Assessed Value American LegalNet, Inc. www.FormsWorkFlow.com