Joseph Berrios COOK COUNTY ASSESSOR APPEAL NUMBER …

1 RECEIVED AND CHECKED BY:20172016 2015 Name of Taxpayer / Owner1 AddressEmail2 CityStateZip CodePhone34 OwnerFormer Owner Liable for TaxTenant Liable for TaxExecutorBeneficiary of Trust5 Other (Explain)6 APPEAL Type:Current Year APPEAL OnlyCurrent Year & C of E C of E OnlyTaxableExemptStreet Address1 CityTownship23 DATA SUBMITTED WITH APPEALDATA TO BE SUBMITTED45 Single Family6 Apartments or LessMixed UseOther (Explain)Check appropriate reason(s) for APPEAL :Lack of UniformityOvervaluationIf purchased on or after January 1, 2015, indicate year purchased and purchase price. If purchased prior to January 1, 2015 insert "prior". Year Purchase PriceVacancy/OccupancyFire DamageProperty Description ErrorBuilding no longer existsSignature of Taxpayer or Attorney / RepresentativeATTORNEY/REPRESENTATIVE CERTIFICATION: IATTORNEY / REPRESENTATIVE NAME (PRINT OR TYPE)FIRM / COMPANY NAME certify that I have obtained fromFIRM / COMPANY ADDRESSCITYZIP PHONE(1) explicit authorization to file this 2018 assessment APPEAL and/or Certificate of Error and(2) the Taxpayers assurance that I am the only attorneyRepresentative so / Representative Fax NumberAttorney / Representative Signature and Code Numbere-mail AddressRESIDENTIALR cook COUNTY ASSESSOR APPEAL NUMBERO ffice Hours: 8:30 5:00 cook COUNTY ASSESSOR 's Office118 N.

2 Clark Street - 3rd FloorChicago, Illinois 60602 Joseph Berrios cook COUNTY Assessor2018 Real Estate Assessed Valuation APPEAL THIS FORM MUST BE PRESENTED IN DUPLICATE. FILE 1ST COPY WITH cook COUNTY ASSESSOR 'S OFFICE - RETAIN TIME STAMPED 2ND COPY FOR YOUR undersigned states that he/she has read this APPEAL , has personal knowledge of the contents thereof, and the same is true in substance and in fact and further so certifies under the penalties as provided by law pursuant to section 1-109 of the Illinois Code of Civil Procedure. NOTE: FAILURE TO FILE OWNER / LESSEE AFFIDAVIT MAY RESULT IN DENIAL OF THIS (if other, you must provide a narrative using the APPEAL narrative form) NATURE OF APPEAL - LOCATION AND IDENTIFICATION OF REAL ESTATE Location of Subject Property:How is the Subject Property used? Check all that / REPRESENTATIVE ONLYTAXPAYER NAMETAXPAYER TITLE OR POSITIONNOTICE TO FILERS:YOU WILL BE NOTIFIED BY MAIL OF THE APPEAL NUMBER . YOU CAN FIND YOUR APPEAL NUMBER AND CHECK APPEAL STATUS ONLINE @ COMPARABLE PROPERTY PINS BELOWSUBJECT PROPERTY PERMANENT INDEX NUMBER (S) [PINS]CERTIFICATE OF ERROR YEAR(S)1 PLEASE COMPLETE ALL PARTS OF THE APPEAL FORM.

3 TYPE OR PRINT ALL INFORMATION. COMPLY WITH ASSESSORS OFFICE RULES AND REGULATIONS IN FILLING OUT AND FILING THIS FORMList in ascending order all Permanent Index Numbers associated with the subject property. IDENTIFICATION AND STATUS OF OWNER / TAXPAYERS elect one:Building is UninhabitableAttorney / Representative Signature and Code NumberField Check RequestedResidential Assessed Valuation APPEAL - Please correct ONLY those property characteristic(s) which are incorrect. - This form is NOT applicable for StoryTwo StoryThree StorySplit to StorySingle Family - One dwelling unitMulti Family - Two to six apartments in one buildingMixed-UseTwoThreeFourFiveSixNone Frame/Siding - At least three entire outside walls are built of wood and/or sidingMasonry - At least three entire outside walls are built of brickFrame/Masonry - At least three entire walls are built of either frame or masonryStucco - At least three outside walls are covered with stuccoYesNoA gas or wood burning fireplace that has a flueOutside perimeter measurementmultiplied by NUMBER of stories ONLYA full bath is a sink, toilet, bathtub, and/or showerA half bath has just a toilet and sinkUse (check one) NUMBER of Total Units (check one)Exterior Construction (check one)Central Air Conditioning (check one) NUMBER of Full BathsApproximate Land Size (Sq.)

4 Feet)Approximate Building Size (Sq. Feet)Type of Residence (check one) NUMBER of Half BathsNumber of FireplacesNumber of Commercial UnitsProperty Index NumberApproximate Age of Home (years)Full Basement - Extends under 3/4 or more of the ground floor areaSlab - No basement, foundation is made of a solid slab of concrete on the groundPartial Basement - Extends under 1/4 to 3/4 of the ground floor areaCrawl Space - No basement, space under the ground floor is less than 4 feet highFoundation or Basement Type (check one)Finished - Basement used as recreation room, study, bedroom or similar living areaApartment - Basement has a separate utility meter and exterior doorUnfinished - Basement not finished as recreation room, study, bedroom or similar living areaBasement Finish (check one)Full - Attic extends over 3/4 or more of the floor area immediately below itPartial - extends over 1/4 to 3/4 of the floor immediately below itNone - No floor above the ground floor, or cannot reach it by a permanent stairwayAttic Size (Attic is the highest floor that you canreach by a permanent stair) (check one)Finished - Attic used as recreation room, study, bedroom or similar living areaApartment - Attic has a separate utility meter and exterior doorUnfinished - Attic not finished as recreation room, study, bedroom or similar living areaAttic Finish (check one)Attached - Garage shares part of any side of the house (if garage is freestanding and connected bya heated breezeway, it is attached) Detached - Garage is entirely separate from the houseGarage Type (check one)1 Car2 Car3 Car4 Car or LargerNoneGarage Size (check one) cook COUNTY ASSESSORJOSEPHBERRIOSCOOK COUNTY ASSESSOR 'S OFFICE118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE.