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2. Internet browser preference

   Please consider using the Google Chrome or Edge browsers. There have been reports of problems with the Firefox browser submitting the form. 

4. EXEMPTION CANCELLATION FORM
6. Parcel Number*
   PIN, Tax ID, Property Identification Number
8. Address of the Property
   Physical address of the property
10. Name*
11. Email Address
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number
21. Please check all exemptions to be removed from this property.*

    1. Owner Occupied
    2. Disabled Person
    3. Disabled Veteran

    1. Returning Veteran
    2. Senior Homestead

    1. Senior Assessment Freeze
    2. Any and All Exemptions
23. Please cancel the above indicated exemptions starting in *
    The year to remove the exemptions
24. You will be required to either show your Driver’s License/State ID or send a photo copy of your driver’s license with this form.
26. If you would rather send this form in by mail:
    Mail completed form and copy of your Driver’s License/State ID to: Supervisor of Assessments Peoria County Courthouse 324 Main St. Room 301 Peoria, IL 61602. Please print out the following confirmation page for proof of cancellation.
28. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature*
31. Date
    Date
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field