Cook County, IL · Cook County
Credit/Refund Application
Cook County taxpayers use this application to request a credit or refund for specified taxes or health insurance payments remitted to the Department of Revenue.
At a glance
- Issued by
- City of Cook County · Cook County, Cook County, Illinois
- Notarization
- Not required: file this form without a notary.
- Official source
- cookcountyil.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a credit or refund for a listed tax or health insurance payment remitted to the Cook County Department of Revenue. File a separate application for each tax and attach supporting documents; the form says unsupported requests will be denied. It asks for taxpayer and account details, the credit or refund period and amount, the reason for the request, and a signed certification.
Who needs it
Taxpayers who meet the listed eligibility conditions and believe they paid or remitted a tax or health insurance payment in error can file this application.
How to submit it
Send the completed application and supporting documents to the Cook County Department of Revenue, Tax Compliance Unit, 118 North Clark Street, Room 1160, Chicago, Illinois 60602-1304.
About notarization
This application is signed without a notary; the signer certifies under penalty of perjury that the application and supporting documents are true and correct.
How to submit this form
- 1
Download the Application
Download the Cook County Credit/Refund Application PDF.
- 2
Complete the Application
Provide your contact and account details, select the tax or payment type, enter the period and amount, and explain the reason for your request.
- 3
Gather Supporting Documents
Attach documents substantiating your claim. The form says requests without supporting documents will be denied.
- 4
Sign and Date the Application
Sign and date the certification that the application and attached supporting documents are true and correct.
- 5
Submit to the County
Send the completed application and attachments to the Cook County Department of Revenue, Tax Compliance Unit, at the address on the form.
Frequently asked questions
- Who can file a Cook County Credit/Refund Application?
- Eligible applicants include taxpayers who paid or remitted a listed tax in error and qualifying health insurance payment remitters. The form gives separate eligibility conditions for each.
- What documents must I attach?
- Attach supporting documents for your claim. The instructions list examples such as copies of both sides of cancelled checks, validated tax returns, invoices, and proof of amounts refunded to customers.
- Do I need a notary for the Credit/Refund Application?
- No. The application is signed without a notary. The signer certifies under penalty of perjury that the application and attached supporting documents are true and correct.
- How do I submit the Credit/Refund Application?
- Send the completed application and supporting documents to the Cook County Department of Revenue, Tax Compliance Unit, 118 North Clark Street, Room 1160, Chicago, Illinois 60602-1304.