Apartment Building More than 6 Units/Stores with Apartments Cook County Board of Review 2011 Complaint No.: Current Assessed Valuation, All Parcels: 2010 Assessed Valuation: Taxpayer’s Request: Appeal Made to Assessor: YES NO Amount of Assessor’s Reduction: Owner Occupied? YES NO % Owner Occupied: APPRAISAL Fair Market Value: As of: Date of Inspection: Taxes: Year: % of Income: Are tenants required to pay any share of taxes: YES NO % and $ If Yes, Total Annual Gross Potential Income, All Sources: $ Economic Analysis Actual Gross Income $ % Occupied (Include all tenant contributions and government subsidies. If government subsidies are received and the taxpayer has been required to file H.U.D. 92410 or I.R.S. 8586, 8609 and 8609 Schedule A, then attach copies to this summary sheet.) RENTAL INCOME # of Rooms/Unit # of Units Are any apartments furnished: YES Rental value of owner occupied space: NO Rent Room/Month sq. ft. Other income (source): Total Rent/Year How many?: Total Units: X Commercal space: Rent Unit/Month = Total Units: annual rent/sq. ft. $ commercial income Annual income: $ Actual Annual Expenses (exclude property taxes, debt service and depreciation) Amount paid by owner Check if paid by Check if paid by apartment tenant commercial tenant Payroll, e.g., janitor, manager $ Gas for heat $ Gas for appliances $ Electric for heat $ Electric for appliances $ W ater & sewer $ Contractual services, e.g., trash, security, exterminator $ Repairs and Maintenance $ Replacement reserve $ Insurance $ Vacancy/Collection loss $ Other $ Explain: TOTAL ANNUAL EXPENSES $ % of Income: Annual Net Income (total income-total expenses) $ Suggested capitalization rate (excluding property taxes): Purchase (on or after January 1, 2008) Tax load: Date: Construction (on or after January 1, 2008) Price: $ Explain if property value was affected by catastrophe or demolition. Is building in housing court or under citation for code violations? Signature: Total: Date: Price: $ YES NO Owner Attorney American LegalNet, Inc. www.FormsWorkFlow.com