7/26/2019 Duplicate or Overpayment of Taxes Form

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Cook County Treasurer

Maria Pappas

DUPLICATE & OVERPAYMENT REFUND APPLICATION

F i l l i n each b l ank be l ow P l ease p r i n t c l ea r l y )

Property Index Number (PIN)

Volume Tax Year Installment

P l ease i nd i c a te where the check w i l l be ma i l ed .

Taxpayer Name In care of

Address Daytime Phone

City/State/Zip E-Mail

I hereby certify under penalty of law that I am legally and equitably entitled to the refund claimed hereby; that I have not previously received all or any part of

a refund from the Office of the Cook County Treasurer or any other party for the same year, Property Index Number and reason; and that if I am not soentitled, I will indemnify and hold the Office of the Cook County Treasurer harmless from any and all adverse claims to such refund, including costs andattorneys fees.

Signature Date

P l ease rev i ew the reverse s i de o f th i s f o rm an d a t t ach any and a l l p roo f o f paym ent ava i l ab l e , such as :

Copy of the front side of the cancelled check(s) used to pay taxes for the tax year in question. You need to submit

only the copy of the check(s) for the installment that has an overpayment or multiple payments.

Copies of the teller receipt or receipted tax bill(s) if paid in cash for the tax year and installment in question.

A letter from any mortgage company, title company or other third party who submitted payment that includes the

following information. (1) P roperty Index Number, (2) t axpayers name, (3 ) amount(s) paid, and (4) date(s) of

payment(s). A copy of your IRS Form 1098 for the corresponding calendar year will be acceptable.

Ma i l t h i s comp le ted app l i c a t ion w i th p roo f o f paymen t a t t ached) to the T reasure r s O f f i c e add res s be l ow.

Incomplete applications or those with insufficient proof of payment may be returned. Additional information on proof ofpayment can be found on the reverse side of this form. Please contact us at www.cookcountytreasurer.com, or call us at(312) 443-5100 with any questions.

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REQUIRED:

Accepted by_____________________ Date_________

Proofed by______________________ Date_________

Entered by______________________ Date_________

Last Revised 1/2012

MAIL ALL APPLICATIONS TO:Cook County Treasurer

Refund Department118 N. Clark Street Room 112

Chicago, IL 60602

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7/26/2019 Duplicate or Overpayment of Taxes Form

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Cook County Treasurer

Accep ted Fo rms o f P roo f o f Paym en t

IF YOU PAID BY CASH

A photocopy of your teller receipt for the tax year and installment where the multiple payment oroverpayment occurred.

IF YOU PAID BY PERSONAL CHECK/BUSINESS CHECK

A photocopy of the front of the canceled check(s) used to pay the taxes for the tax year andinstallment where the multiple payment or overpayment occurred.

IF YOU PAID BY CASHIERS CHECK/MONEY ORDER

A photocopy of the customer receipt, or the front of t he check o r money order for the tax year andinstallment where the multiple payment or overpayment occurred.

NOTE: If you cannot locate a copy of the canceled check(s) used to pay taxes, you may submit a copyof the monthly bank statement that shows the corresponding check number and amount of payment.

IF YOU PAID BY ON-LINE PAYMENT AT www.cookcountytreasurer.com

Your bank statement indicating the successful transfer of funds to the Cook County Treasurer's Officefor the tax year and installment where the multiple payment or overpayment occurred.

IF YOU PAID THROUGH YOUR MORTGAGE COMPANY, BANK OR TITLE COMPANY

A statement or letter from the company indicating: (1) Property Index Number, (2) taxpayers name(3) taxpayers address, (4) amount(s) paid, and (5) date(s) of payment(s).

HELPFUL TAXPAYER TIP: One shortcut for proof of a mortgage company payment is to use a copy ofyour IRS Form 1098. This record, which most taxpayers keep with their income-tax files, is the formthat the mortgage company sends to report the interest you paid and the taxes the company paid on

your behalf. This is especially useful if you refinanced, your loan was sold, or the mortgage companyfor a past tax year cannot be contacted. Be sure to submit the correct calendar year copy of the IRSForm 1098 record

. (For example, the 2011property taxes were due in calendar year 2012. As suchyour 2012IRS 1098 form would be your proof of payment for the 2011property taxes in most cases.)

IF YOU PAID MULTIPLE PARCELS WITH ONE CHECK

For each refund requested, a list of the PINs paid with that check must be provided with a copy of thefront of the check for the installment where the multiple payment or overpayment occurred.

If you have questions, contact us at www.cookcountytreasurer.com, or (312) 443-5100.

W HY IS IT IMP ORTAN T TO SUBM IT PROOF OF PAYM ENT?

The Of fi ce o f Cook County T reasu rer M a r i a Pappas he lp s homeow ner s and o the r t axpaye r s

obta in re fund s they are en t i t l ed to rece ive .

P l ease no te t ha t p rope r ty - t ax payment s a re made on a P rope rt y I ndex Num ber P IN ) tha t

represents the lega l descr ip t ion o f your hom e or other proper ty . Var ious par t ies m ay have

pa id taxes on tha t PIN . Because of d i f f e rent c i rcum stances , re funds can go to the cur rent

ow ner , pas t ow ner , or a th i rd par ty . P roof o f paym ent i s requ i red to ensure that re funds go

on l y t o t hose who pa id t he t axes on the ove rpa id P IN . P roo f o f payment he lp s p reven t

those who f i le f raudu lent c la im s f rom obta in ing a re fund.