Step 1 – Prohibited Buildings Registration

Prohibited Buildings Registration (Step 1)

Affidavit For Inclusion in the Short-term Rental Prohibited Buildings List

Step 1 of 3

Fill out, verify and submit this online form. Once it is submitted you will be able to download and print a PDF document with the information you have entered. This affidavit document must be signed, notarized and submitted to the Department of Business Affairs and Consumer Protection for review. After the review is complete and the affidavit is approved, the building will be added to the Prohibited Buildings List.

Required fields are marked with a

Applicant Name (First Name, Last Name)

Phone Number (e.g. 111-222-3333)

Street Number

Street Direction

Street Name

Street Type

Suite/Floor/Etc.

City

State

Zip (e.g. 60699)

Zip+4 (Optional)

Building Information: (For buildings with address ranges use full street numbers e.g. 2420-2450)
If prohibited buildings are in a range on both sides of the street, submit an Affidavit for each contiguous range of Odd and Even addresses.

Street Number

Street Direction

Street Name

Street Type

Property Index Number (PIN) (e.g. xx-xx-xxx-xxx-xxxx)

Subject Property Contains Number of Dwelling Units

Check one of the following five (5) statements:

For Owner or Registered/Authorized Agent of Owner

	1.	As the owner of the building at the Subject Property,
	2.	As the registered agent, as recorded with the Illinois Secretary of State, of the owner of the building at the Subject Property,
	3.	As the legally authorized agent (agent title) of the owner of the building at the Subject Property,
I confirm that I am prohibiting short-term rental of dwelling units (i.e. rental or occupancy of a dwelling unit for 31 or fewer consecutive days) in the entire Subject Property.

For Registered/Authorized Agent of Board/Association/Building Cooperative

		Association/Board/Building Cooperative Name:

		I am the Registered Agent, as recorded with the Illinois Secretary of State or
		I am the Authorized Agent (agent title) for the above-named Board/Association/Building Cooperative.
	4.	As the registered/authorized agent I am legally authorized to represent the above named Board/Association. I attest that on (date of vote), said Board/Association voted, in accordance with the Illinois Condominium Property Act, to prohibit short-term rental of dwelling units (i.e. rental or occupancy of a dwelling unit for 31 or fewer consecutive days) in the entire Subject Property.
	5.	As the registered/authorized agent I am legally authorized to represent the above named Board/Association/Building Cooperative. I attest that pursuant to governing instruments (e.g. declaration of condominium, bylaws, rules, proprietary lease, etc.) of said Board/Association/Building Cooperative, short term rental of dwelling units (i.e. rental or occupancy of a dwelling unit for 31 or fewer consecutive days) is prohibited in the entire Subject Property.
Therefore, in accordance with Section 4-13-260(a)(9) of the Municipal Code of Chicago, please include the above listed Subject Property in the Prohibited Buildings List. I, the undersigned, hereby certify under penalty of perjury and other penalties as provided by law, including, but not limited to, the False Statements Ordinance, Chapter 1-21 of the Municipal Code of Chicago, that I have read this affidavit and have personal knowledge of the contents thereof, and that the statements contained herein are true and correct.