2. Property Address:   ___________________________________________ 

    

   
   

    

   Eligibility Requirements

    

   1. Applicant must be 65 years of age or older or disabled 
   2. Property must be applicant’s primary residence 

    

   Documentation Requirements

    

   1. Proof of age:                                                                                             
      • Valid Illinois Driver’s License or State ID with North Riverside address 
   2. Proof of disability 
      • Latest 2^nd Installment Cook County Tax Bill showing Disabled Exemption.  Tax bill must be in applicant’s name 
   3. Proof of primary residence 
      • Latest 2^nd Installment Cook County Tax Bill with Senior Homestead Exemption.  Tax bill    must be in applicant’s name. 

                                    ^OR 

   • Current lease in applicant’s name. 

    

   I certify the above information is accurate and the property is my principal residence. 

    

    

   ______________________________________________                      ______________ 

   Signature                                                                                                            Date 

    

   Discount will be applied within 1 billing cycle of application approval  

   Print and Submit TO: Village Of North Riverside 

   2401 S. DESPLAINES AVENUE ● NORTH RIVERSIDE, IL  60546

   PHONE: 708-447-4211 ● FAX:  708-447-4292

   
   

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