(35 ILCS 516/215)
    Sec. 215. Scavenger sale; application for certificate of purchase. The application for certificate of purchase shall be executed by the purchaser and by any individual bidder acting in the purchaser's behalf. The application shall be initially executed and delivered to the county clerk at the time of registration for the sale as provided in this Section. Before receiving any certificate of purchase, each purchaser and individual bidder acting in the purchaser's behalf shall sign and deliver to the county clerk a schedule or schedules of the mobile homes for which that purchaser has successfully bid and is applying to purchase, which schedule or schedules shall be attached to and incorporated within the application. The schedule or schedules shall be accompanied by a fee, for each mobile home listed, of $10 in counties with less than 3,000,000 inhabitants. The application and schedule or schedules shall be in substantially the following form:
APPLICATION FOR CERTIFICATE OF PURCHASE
Date of Application: ...............
Name of Purchaser: .................
Address: ...........................
Name of Bidder: ....................
Address: ...........................
    I (we) hereby apply to the County Clerk and County Treasurer of ..... County for issuance of a certificate of purchase for each of the mobile homes on the attached schedule(s), and state as follows:
    1. I (we) made (or authorized) the successful bid on each mobile home listed on the attached schedule or schedules at the sale of delinquent mobile homes under Section 200 of the Mobile Home Local Services Tax Enforcement Act conducted by the County Treasurer of ..... County, Illinois, on the dates indicated for each mobile home on the schedule(s).
    2. At least 5 business days before the first day of this sale, I (we) submitted a truthful, accurate and complete registration to the Treasurer of ..... County on the form(s) and according to the regulations prescribed by the Treasurer's office.
    3. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent of an owner, lienholder or agent of a lienholder (other than the mobile home park owner or his or her agent), holder of beneficial interest or agent of a holder of a beneficial interest in or of any mobile home identified on the schedule(s) attached to this application on January 1st of any years for which taxes were delinquent at the time of my (our) bid(s) described in the schedule(s).
    4. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent of an owner, lienholder or agent of a lienholder (other than the mobile home park owner or his or her agent), holder of a beneficial interest or agent of a holder of a beneficial interest in or of the mobile home identified on the schedule(s) attached to this application at the time of the bid(s) described in the schedule.
    5. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent for an owner, or party or agent for a party responsible for the payment of delinquent taxes, on any mobile home in the county that was tax delinquent or forfeited for all or any part of each of 2 or more years when the registration was submitted.
    6. Neither I (we) nor any person acting in my (our) behalf has twice failed to complete a purchase at the sale during which the mobile homes on the attached schedule(s) were offered by failing to immediately pay a minimum bid or by failing to pay the balance of a bid for any mobile home within one business day thereafter.
    I (we) hereby affirm that I (we) have read this application and that the statements made in it are personally known by me (us) to be true, accurate and complete, under penalty of perjury as provided by law.
    I (we) further understand that this application shall be void unless the schedule(s) of mobile homes referred to in the application is (are) completed and delivered to the County Clerk.
........................                                                                              Dated: ..............
(Signature of Purchaser)
........................                                                                              Dated: ..............
(Signature of Bidder)
SCHEDULE OF PROPERTIES
Mobile home vehicle identification number
(or other identification)                                                                                            Date of Bid
(insert number or other identification)                                                                    (insert date)
    I (we) hereby affirm that I (we) successfully bid upon the above mobile homes at the sale conducted by the County Treasurer of ..... County on the indicated dates, and I (we) request that the County Clerk of ..... County attach this schedule to my (our) application for certificate of purchase dated ......
    Signed under penalty of perjury as provided by law:
........................                                                                              Dated: ..............
(Signature of Purchaser)
........................                                                                              Dated: ..............
(Signature of Bidder)
(Source: P.A. 92-807, eff. 1-1-03.)