Chicago Energy Benchmarking Exemption Form – Financial Distress
Instructions:
Please use this form to apply for a temporary exemption for a covered building experiencing financial distress. Qualifying buildings include those that are subject to a qualified tax lien sale or public auction due to property tax arrearages, controlled by a court appointed receiver, or acquired by a deed in lieu of foreclosure.
This form should take approximately 10 minutes to complete. Within 10 business days, you will receive an email confirmation and/or any follow-up questions about your request.
*
required fields
Section 1: Contact Information
First Name
Last Name
Title
Company
Relationship to Building
Please select...
Building Engineer
Energy Manager
Owner
Property Manager
Energy Benchmarking Verifier
Vendor or Service Provider
Other
Please let us know the other relationship to the building.
Email
Phone
Section 2: Building Information
Please Provide Chicago Energy Benchmarking ID
Six-digit ID number listed on building’s Notification of Obligation to Comply letter; if ID is unknown, request it using
this form
.
Building Name
Building Address (to be Benchmarked)
City
State
Zip
Section 3: Financial Distress
Owners of covered buildings experiencing qualifying financial distress may be eligible for a 2024 exemption.
Check one or more boxes below to request an exemption based on the following:
The building is the subject of a qualified tax lien sale or public auction due to property tax arrearages.
The building is controlled by a court appointed receiver.
The building has been acquired by a deed in lieu of foreclosure.
Section 4: Notes
Please use this section to identify additional addresses that may be associated with the building, including any addresses that had been assigned a Chicago Energy Benchmarking ID but which should be included under the primary address above. Please also add any other notes or comments about the building here.
Section 5: Signature of Authorized Building Representative
Any person who knowingly makes a false statement of material fact in connection with this application shall be sanctioned under, among other applicable law, the City of Chicago's False Statements Ordinance (Chapter 1-21 of the Municipal Code of Chicago).
I, the undersigned authorized representative of the building, affirm and attest to the accuracy, truthfulness and completeness of the statements of material fact provided in this form.
Name
o
Please indicate your agreement by typing in your full name above
Email
Questions? We Can Help!
Call the Chicago Energy Benchmarking Help Center at (855) 858-6878 (M-F, 9am-5pm) or email
Info@ChicagoEnergyBenchmarking.org
.
Contact Information