Ptax-300-Fs Form - Application For Federal/state Agency Property Tax Exemption
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Illinois Department of Revenue
PTAX-300-FS
Application for Federal/State Agency Property Tax Exemption
County reference number: __________________________________ IDOR docket number: ____________________________________
County use only
IDOR use only
Step 1: Identify the property
4
1
Write your agency parcel no. ____________________________
___________________________________________________
County in which property is located
5
Write the acreage. ____________________________________
2
___________________________________________________
6
Property owner
Write the property index numbers (PINs). If a partial take, write
a “P” at the end of the PIN. If you have additional PINs, attach a
3
separate sheet.
___________________________________________________
a
Contact person
PIN __________________________________________( )
___________________________________________________
b
Mailing address
PIN __________________________________________( )
___________________________________________________
c
City
State
ZIP
PIN __________________________________________( )
(_______)___________________________________________
Daytime phone
You must attach the legal description of the portion of the
parcel you are taking.
Step 2: Complete the following information
7
Write the date the deed or contract
9
Is any income derived from this property?
Yes
No
for deed was executed. ___ ___ / ___ ___ / ___ ___ ___ ___
Attach a copy of any contract or lease.
M onth Day Year
Attach a copy.
1 0
If granting this application will reduce the property’s assessed
8
If by eminent domain proceedings,
valuation by $100,000 or more, has the municipality, school
write the case number. _________________________________
district, community college district, and the fire protection
Attach a copy.
district in which the property is located been
a
Date filed ___ ___ / ___ ___ / ___ ___ ___ ___
notified that this application has been filed?
Yes
No
M onth Day Year
Attach a copy of notices and postal
b
return receipts.
OVT date ___ ___ / ___ ___ / ___ ___ ___ ___
M onth Day Year
Step 3: Sign below
I state that to the best of my knowledge, the information on this application is true, correct, and complete.
_______________________________________________________
___ ___ / ___ ___ / ___ ___ ___ ___
M onth Day Year
County official use only. Do not write in this space
Step 4: County board of review
1
Current assessment $__________________________________
For assessment year 2______
2
County board of review recommendation
___ Full year exemption
___ Partial year exemption from ___ ___ / ___ ___ / ___ ___ ___ ___ to ___ ___ / ___ ___ / ___ ___ ___ ___
___ Partial exemption for the following described portion of the property: ___________________________________________________
__________________________________________________________________________________________________________
___ Deny exemption
3
Date of board’s action ___ ___ / ___ ___ / ___ ___ ___ ___
Step 5: County board of review certification
I certify this to be a correct statement of all facts arising in connection wth proceedings on this exemption application.
Mail to: OFFICE OF LOCAL GOVERNMENT SERVICES MC 3-520
_______________________________________________________
Signature of clerk of county board of review
ILLINOIS DEPARTMENT OF REVENUE
101 WEST JEFFERSON STREET
SPRINGFIELD IL 62702
PTAX-300-FS (R-12/09)
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