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01. Edit your il application certification online
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How to use or fill out the Illinois CB Application with Our Platform
- Click ‘Get Form’ to open the Illinois CB application in the editor.
- Begin by filling out the Applicant Information section. Enter your last name, first name, middle initial, street address, city, state, ZIP code, driver’s license number, employer number, social security number, and date of birth.
- Review the declaration under penalty of perjury. Ensure you understand and affirm that you have not been convicted of disqualifying offenses and that all information is accurate.
- Sign and date the application in the designated areas to confirm your consent and certification.
- If applicable, complete the New Applicant section by marking each requirement box and providing completion dates as required by your employer.
- For reapplicants, ensure you mark the appropriate box regarding your D.O.T. Medical Examination and indicate its validity date.
- Employers must complete their sections accurately, including signatures and contact information before submission.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2006 | 4.8 Satisfied (212 Votes) |
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Does Illinois still have the circuit breaker?
The Benefit Access Program, formerly known as Circuit Breaker, is for qualified seniors and disabled citizens to receive help with transit rides and license plate discounts. For qualification information, you should contact the Illinois Department of Revenue.
Who qualifies for the Illinois benefit access program?
65 years of age or older before January 1 of the current year; or You must become 65 years of age this year; or You must be 16 years of age or older before January 1 of the current year and qualify as disabled. Residency Requirements: You must live in Illinois at the time you file your application.
What is the income limit for Illinois Department on Aging?
$55,500 for a 3 person household (yourself, your spouse and one Qualified Additional Resident, or yourself and two Qualified Additional Residents).
How do you qualify for circuit breaker in Illinois?
Review the eligibility requirements to see if you are able to enroll. Briefly, Circuit Breaker is for Illinois Residents, age 65 or older or with a disability, and who meet certain income requirements.
How do I apply for a circuit breaker in Illinois?
Income Limit Eligibility for the License Plate discount and/or Ride Free Transit Card: (Income limit increase effective 1/1/2020.) $55,500 for a 3 person household (yourself, your spouse and one Qualified Additional Resident, or yourself and two Qualified Additional Residents).
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