Lincoln Avenue SSA Reconstitution Signature of Support

By entering the information below, you are indicating that you agree with the statements below. This information will be kept confidential and may be used for future communication with you regarding the Lincoln Avenue Special Service Area (SSA) program. Please fill out this form completely.

For more information about the Lincoln Avenue SSA #35, please visit LincolnAveSSA.com or call the Lincoln Park Chamber of Commerce at (773) 880-5200.

Question Title

Existing and proposed Lincoln Ave. SSA Boundaries

Question Title

* 1. I am the TAXPAYER, OWNER OF RECORD, or AUTHORIZED AGENT THEREOF of the property listed below, which is located within the boundary of the existing/proposed Lincoln Avenue Special Service Area (SSA) #35.

PIN#(S)*:

PROPERTY ADDRESS(ES):

NAME OF TAXPAYER:

NAME OF SIGNATOR:

TITLE (IF AUTHORIZED AGENT):

PHONE:

EMAIL:

Question Title

* 2. I am in support of the Lincoln Avenue SSA #35 and the public way maintenance and economic development programs the SSA will provide. I believe the SSA will provide the resources needed to ensure that the area is a clean and vibrant place to live and do business.

Please type your full name in the box below for your E-Signature.

*If you do not know your 14-digit Property Index Number (PIN), you can find it on your most recent tax bill, search by address at http://www.cookcountyassessor.com/newsearch.aspx or call the Lincoln Park Chamber of Commerce office at (773) 880-5200.

If you have any questions about the Lincoln Ave SSA or this form, please call the Lincoln Park Chamber of Commerce at (773) 880-5200.

Please click "Submit" below to submit your signature of support.