COOK COUNTY ASSESSOR
FRITZ KAEGI
Cook Seal
COOK COUNTY ASSESSOR's OFFICE
118 NORTH CLARK STREET, CHICAGO, IL. 60602
PHONE 312.603.4137 FAX 312.603.6584
www.cookcountyassessor.com

COOK COUNTY ASSESSOR’S OFFICE
Cook County Farmland Questionnaire/Affidavit

Before you begin, please make sure you have the following required items::
  • The Property Address.
  • The PIN (search for it by address here).
  • The name of and valid e-mail address of the owner filing this affidavit.
As the owner of a property receiving a Farmland Incentive, you are required to file a completed affidavit with the Cook County Assessor’s Office. Please complete the affidavit and include all Permanent Index Numbers participating in the program.

The deadline for returning the affidavit is January 31 of each year you are in the Freeze Program. Failure to file a completed affidavit, with the correct information by the required deadline, may result in the removal of the property from the Farmland program.

Please provide the following information:
Property and PIN(s)
Township:
Address of the Property:
Farm Agency Number (optional):
Owner
Owner Name:
Owner Address:
Owner City:
Owner State:
Owner Zip:
Owner Daytime Phone:
Email Address:

Please upload a copy of your current Illinois Driver’s License or State ID:

Please note: Only images (.png, jpg), Word (.doc, .docx) or PDF (.pdf) documents will be accepted.

I, as the owner or agent of the subject property, swear that the following is true and correct:


  1. I am liable for the property taxes on each of the properties on the attached Property List and hereby request that said properties be valued as property used for farmland purposes pursuant to 35 ILCS 200/10-110 and 35 ILCS 200/1-60.
  2. Are all of these listed parcels assessed as farmland?  
    If not, please indicate with an asterisk (*) (check IsAssessable below) on the PIN when listing it on the Property Index Number (PIN) List.

  3. Specify the farmland use for the listed parcels for the two preceding years:
    January 1, 2022 to December 31, 2022
    January 1, 2023 to December 31, 2023
    Proposed 2024 farmland use
  4. This property listed as farmland is farmed by:
    • Owner Operator -
      • Does the owner-operator reside on the said farm?
      If yes, how many acres are devoted to farming?
      How many acres are devoted to residential use?
    • Lessee or tenant (if such, complete the requested info below)
      • Name:
      Address:
      City:
      State:
      Zip:
      Daytime Phone:
      Email Address:
  5. Please indicate any income other than income from farmland use for the land:
  6. For land that may be eligible, give estimates of acreage in each category:

    Acres tillable land:  Acres tillable land but not farm:  Acres not farmed due to:
  7. Total number of improvements on parcel(s):

    Residences:  Storage Buildings:  Seasonal Farming Stands:  Barns:  Silos:  Residential Garages: 
  8. Specify the annual income to owner from farm parcels either from rent or farmland sale:

    2022:  2023: 

PIN LIST

Taxpayer of Record:
Property Index Number(s) (up to 15 PINs):
Total Acreage:
Acreage Tillable:
Acreage Farmed:
Not Farmed:
This PIN is Assessable   pin icon

COOK COUNTY ASSESSOR’S OFFICE
Farmland Affidavit

Legal Notice:

The filer of this form certifies and attests to the accuracy of all of the information provided in the form, either from personal knowledge or from knowledge derived from others whom the filer has ascertained do have personal knowledge of the information provided in the form. Additionally, the filer certifies that he or she has reviewed all the infonmation provided and certifies that the information accurately represents the facts pertaining to the habitation or leasing of the real estate in question. The filer acknowledges that filing false or fraudulent infonmation with the Assessor's Office, with the intent to defeat or evade the law in relation to the assessment of the property, is a Class A misdemeanor under section 25-40 of the Property Tax Code. 35 ILCS 200125-40.

All submitted information is subject to review in accordance with applicable law and the policies of the Cook County Assessor's Office If any information you have provided in this certification changes, you must notify the Cook County Assessor's Office immediately. We recommend that you keep a copy of this certification for your records.

Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he verily believes the same to be true.

CURRENT OWNER OR TITLEHOLDER OF RECORD
Name of Current Owner of Titleholder of Record:
Street Address:
City:
State:
Zip Code:
Telephone Number:
Email Address:
Signature of Current Owner:

After submitting this affidavit online, you will be able to download a copy as well.