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ASSESSMENT INFORMATION ON SOLD PROPERTIES <br /> This page is to be completed by the County Assessor or Supervisor of Assessments. The form is to be mailed to <br /> Illinois Department of Revenue, 101 West Jefferson, P.O. Box 19033, Springfield, IL 62794-9033 <br /> after being processed by county personnel. <br /> 1. ENTER BRIEF LEGAL DESCRIPTION OF PROPERTY AS IT APPEARS ON ASSESSMENT BOOKS. <br /> 2. INSTRUCTIONS FOR COMPLETING PROPER'TY DESCRIPTION CODES: <br /> (a) Enter Permanent Real Estate Index Number.Enter the property use code in the Unit No. boxes ff using the IL Real Property Appraisal Manual,or circle the appro- <br /> priate letter if using the codes in the IL Property Tax Manual.Enter the assessment Quadront"rf applicable. <br /> (b) County&Township: Use codes from Oepartment Cade Sheets. (d) Date of Deed: Enter month and year from Page 1 of declarotion. <br /> (c) Class of Property: For Cook County,see Property Type Code Sheet. (e) Acreage: For Class 51 and 61 Property,enter�umber of acres; <br /> For pownstate Counties: enter <br /> for Class 71 and 81 Property,leave blank. <br /> 51 (if assessed as farm(14125)with no building) 71 (assessed as nonfarm with no building) <br /> 61 (if assessed as farm(10-125 and 10-140)with a building) 81 (assessed as nonfarm with a building) <br /> PERMANENT REAL ESTATE INDEX N0. <br /> �a� � � � � �B❑ � �PA❑L� � � I❑ � / F' CircleFOne �. R � <br /> ASSM T. <br /> QUAD. <br /> ❑ ❑ ❑ Comments by Supervisor of Assessments or Courrty Assessor; <br /> (b) County <br /> Township ❑ ❑ ❑ <br /> (c) Class � ❑ <br /> Mon��t--h --�� Y�yr <br /> (d) Date of Deed ❑ i � ❑ ❑ <br /> u <br /> (e) Acreage(Round to � ❑ ❑ ❑ <br /> nearest full acre) <br />' 3. ASSESSED VALUE DATA <br /> Enter assessed value as finally adjusted by the Board of Review or Appeals for the year prior to the date of sale. <br /> Where assessment is partial or split,designate with a large"P"or"S"on the assessmertt boxes. I hereby certity that the information shown relates <br /> YEAR PRIOR TO SALE 19 The following questions must be answered: to the property described in the declaration a�d <br /> Book No. Page Line Yes No <br /> 1. ❑ ❑ Is this a 14125,formerly 20e,assessment?("Farm 8ill") that the assessed valuations are for the property <br /> 2. ❑ ❑ Is this a partial assessment?(i.e.,improvement not com- included in the transfer. <br /> pleted on assessment date) <br /> 3. ❑ ❑ Will a split(divisbn)be required to refkct the legal <br /> description on this deed(or Trust Document)? Dated this day of <br /> 4. ❑ ❑ Has an improvement been added or rertw�ed since <br /> January 1 of the year prpr to the sale,but before the <br /> sale date? , 19 <br />� Land ❑ , ❑ ❑ ❑ , ❑ ❑ ❑ 5. ❑ O pP�ls a�ion�fa the year ind'Kat B(includirng Board <br />' g�dgs. � � � � � � � of Review equaliration factors)? <br /> ❑ ❑ ❑ ❑ ❑ ❑ � � 6. ❑ 0 Is this a 1430,formerly 20g-4,assessment? <br /> Total 7. ❑ ❑ If sale inwlves a mobile home,is the mobik home Supervisor of Assessments or County Asseswr <br /> assessed as real estate? <br /> FOR DEPARTMENT USE ONLY <br /> Full Consideration <br /> ❑ ❑ Mukiple Parcel Indicator <br />, ❑ ❑ , ❑ ❑ ❑ , ❑ ❑ ❑ <br /> Adjusted Consideration File Maintenance <br />' ❑ ❑ , ❑ ❑ ❑ , u ❑ ❑ TabNumber: <br /> This form is authorized in accordance with 35 ILCS 200/1-1 et seq.Disclosure of this information is REQUIRED.This fortn <br /> Page 4 Of 4 has been approved by the Fortns Mana9ement Center. IL-492-0227 � SOY BASE INK <br /> ��RECYCLED PAPER PTAX-203(R-4/94) <br />