R90-102 AUTHORIZING CONVEYANCE OF PROPERTY AND ACCEPTANCE OF PROPERTY

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� ASSESSMENT INFORMATION ON SOLD PROPERTIES i � This page is to be completed by the County Assessor or Supervisor of Assessments. The form is to be mailed to Illinois Department of Revenue, 101 West Jefferson P.O. Box 4058 , , , Springfield, IL 62708 1. ENTER BRIEF LEGAL DESCRIPTION OF PROPERTY AS IT APPEARS ON ASSESSMENT BOOKS. 2. INSTRUCTIONS FOR COMPLETING PROPERTY DESCRIPTION CODES: (a) Enter Permanent Real Estate Index Number.Enter the property use code in the Unit No. boxes if using the IL Real Property Appraisal Manual,or circle the appro- priate letter ii using the codes in the IL Property Tax Manual.Enter the assessment Quadrant if applicable. (b) County&Township: Use codes from Department Code Sheets. (d) Date of Deed: Enter month and year from Page 1 of declaretion. (c) Cfass oi Property: For Cook County, see Property Type Code Sheet. (e) Acreage: For Class 51 and 61 Property,enter number of acres; for Class 71 and 81 Property,leave blank. For pownstate Counties: enter 51 (if 5 acres or more with no building) 71 (if under 5 acres with no building) 61 (if 5 acres or more with a building) 81 (if under 5 acres with a buildingl PERMANENT REAL ESTATE INDEX N0. (a) ❑ ❑ a ❑ ❑B❑ � ❑PA❑�❑ ❑ ❑ �❑ ❑ / F' Circle One I R p3S�M'T. QUAD. ❑ ❑ ❑ Comments by Supenisor of Assessments or County Assessor. (b) County Township � � � (c) Class � � Month Year (d) Date of Deed � � � � (e) Acreage(Round to ❑ ❑ ❑ � � nearest full acre) 3. ASSESSED VALUE DATA Enter assessed value as finally adjusted by the Board of Review or Appeals for the year prior to the date of sale. Where assessment is partial or split;designate with a large"P"or"S"on the assessment boxes. I herebycertifythat the information shown relates YEAR PRIOR TO SALE 19 The followin to the property described in the declaration and Book No. Page Line B Questions must be answered: Yes No that the assessed valuations are for the property 1. ❑ ❑ Is this a 20e assessment?("farm Bill") included in the transfer. 2. O ❑ Is this a partial assessment?(i.e.,improvement not com- pleted on assessment date) 3. ❑ O wll a split(division)be required to reflect the legal Dated this day oi description on this deed(or Trust Daument)? 4. ❑ C Has an improvement been added or removed since 19 ❑ ❑ ❑ ❑ ❑ ❑ ❑ January 1 of the year prior to the sale,but before the �— • Land sale date? � ❑ ❑ ❑ ❑ � ❑ 5. O ❑ Does assessment shown reflect all Board of Review or Bldgs. Appeals action for the year indicated(including Board Total ❑ ❑ , ❑ � � , � � � of Review equalization factors)? Supervisor of Assessments or County llssessor 6. O O Is this a 20g�4 assessment?(Public Act 83-837) FOR DEPARTMENT USE ONLY Full Consideration ❑ LJ Multiple Parcel I�dicator ❑ ❑ � ❑ ❑ ❑ , ❑ ❑ ❑ �Ad usted Consideration File Maintenance � r � ❑ ❑ , ❑ ❑ ❑ TabNumber: Page 4 FTAB-203(R-12!85)