Ordinance O2011-599 Passed

COUNCIL MEETING January 13, 2011 ORDINANCE SECTION 1: Pursuant to Section 3-12-050 of the Municipal Code of Chicago the following persons are hereby entitled to a Fifty ($50.00) Senior Citizen Sewer Charge Refund to be mailed to the premises hereunder or reported on the attached list: SECTION 2. This ordinance shall take effect upon its passage and publication. (1 attached) Helen Shiller Alderman 46th Ward 1 Lynn Welter 4707 N. Magnolia Apt. 1S Chicago, IL 60640 Chicago City Council - Committee on Finance - Application for Senior Citizens Sewer C. Page 1 of 1 City of Chicago Claim Form Application For Senior Citizens Sewer Charge Annual Refund Fill in the fields below and print form. Sign and take this to your alderman's office. FOR OFFICIAL USE ONLY CLAIM*_ WARD__ DATE_' STATUS_■ R_ Note: *AII Fields Must Be Filled In Claimant Name Lynn Welter Claimant Address 4707 N. Magnolia Ave., #1S Claimant City, State & Zip Code Chicago , IL 60640 Claimant Telephone Office NA Home 773-275-5717 Cellular NA Claimant Birthdate: 10/02/1943 Property Tax Number: PIN 14 - 17 - 105 - 023 1004 Water Account Number: Building Type: Condo Com Units 0 Res Units 8 I, .(print your name), the undersigned on 11 oath deposes and states that I am the applicant on this application, that I am the owner of record of said real estate property or that I have a legal or equitable interest therein, that I am 65 years of age or older, and otherwise qualify for a refund under Section,3-12-050 of the Municipal Code of the City of Chicago, that all water taxes, property taxes, and all other fees, penalties or assessments owed to the City of Chicago have been paid and that I understand I am subject to penalties for perjufy or falsification herein. OWNER SIGNATURE:^ DATE: Edit Form - Print this claim form Please print this and return application to your aldermanic office before July 1 © 2007 Chicago City Council - Committee on Finanace. All Rights Reserved