Building Permit Applicant Debt Check Request Form

Please use this form to request a debt clearance certificate from the Department of Finance in connection with a building permit application.

The debt clearance certificate will be valid for 120 days from issuance. Currently, this website may ONLY be used in connection with building permit applications under the Self-Certification Program.

A debt clearance certificate obtained through this site will not be valid under any other permit or licensing process. Attempting to use a debt clearance certificate obtained through this website in connection with any other permit or licensing process may delay processing of your permit or license application.

Who is requesting this Debt Clearance Certificate?

Requests may only be filed by a registered self-certification architect or licensed expediter.

Architect/Expediter Name (*)

Registration / License Type (*)

Registration / License Number (*)

Phone Number (*)

Email Address (*)

The debt clearance certificate will be sent to this e-mail address.

Building Permit Information

Street Address (*)

This must match the address used on the permit application exactly.

Estimated Application Date

Permit Applicant Information

This must match the information that you provide on the building permit application.

Name (*)

Street Address (*)

City (*)

State

Zip Code

Country

What type of address is this? (*)

Driver's License State/Number

Providing this info will expedite processing.

Is Permit Applicant a corporation, partnership, limited liability company or other legal entity? (*)

No Yes

Permit Applicant Information (continued)

Does any person or entity own, directly or indirectly, more than 25 percent of the Permit Applicant? (*)

No Yes

Because the applicant is a corporation, partnership, limited liability company or other legal entity, you must disclose each person or entity owning, directly or indirectly, more than 25 percent of the interest in such applicant or owner:

Permit Applicant: Person or Entity 1

Name (*)

Address (*)

City (*)

State

Zip Code

Country

What type of address is this? (*)

Driver's License State/Number

Providing this info will expedite processing.

Permit Applicant: Person or Entity 2

Name

Address

City

State

Zip Code

Country

What type of address is this?

Driver's License State/Number

Providing this info will expedite processing.

Permit Applicant: Person or Entity 3

Name

Address

City

State

Zip Code

Country

What type of address is this?

Driver's License State/Number

Providing this info will expedite processing.

Property Owner Information

Is Permit Applicant the sole owner of the property where the work is to be performed? (*)

No Yes

Property Owner Information (continued)

Because the Permit Applicant is not sole owner of the property where work is to be performed, you must disclose each owner of the property, other than Permit Applicant:

Property Owner 1

Name (*)

Address (*)

City (*)

State

Zip Code

Country

What type of address is this? (*)

Driver's License State/Number

Providing this info will expedite processing.

Property Owner 2

Name

Address

City

State

Zip Code

Country

What type of address is this?

Driver's License State/Number

Providing this info will expedite processing.

Property Owner 3

Name

Address

City

State

Zip Code

Country

What type of address is this?

Driver's License State/Number

Providing this info will expedite processing.

Additional Information

Please provide any additional information that you would like the Department of Finance to consider.

(You have 1000 characters remaining)

Verification

I certify that all information provided in this form is true and complete.

I understand that if I submit false, inaccurate, or incomplete information using this form, the City of Chicago may revoke any resulting building permit and impose other penalties provided by law. A false statement of material fact made using this form may violate federal, state and/or local law, and may subject any person making such a statement to a range of civil and criminal penalties, such as a period of incarceration, fines, and an award to the City of Chicago of up to three times any damages incurred. In addition, submission of false information may result in denial of the requested City action.

Please ensure all of the information you entered above is accurate and complete before clicking submit.
For any debt related questions, please contact the Department of Finance at PermitReviews@cityofchicago.org.

Building Permit Applicant Debt Check Request Form

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