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Application for Proration of Property TaxesFor county use only Due to Damage by Fire or Act of God oats recei°� Oregon Revised Statutes(ORS)308.425 L(r\le-<1!)ti \ Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this may reduce the amount of tax due or result in a tax refund.The tax year is from July 1 to June 30. •Your application must be filed within 60 days of the damage or by June 30 of the tax year in which the damage occurred,whichever is later. •Ale your application with the county tax collector of the county in which your damaged property is located. Applicant's name CW SPECIALTY LUMBER(along with)COOPER WAGNER PROPERTIES LLC Phone Mailing address 503-551-8933 PO BOX 1159 Email(optional) City chris@cwIumber.com Mill City State DP code OR `97360 Location and description of damaged or destroyed property Assessor's account number 335279.A 111320 Z S a 7e? Location of property(if different from above) Section TownshipRange Tax lot number 27622 River Rd.SE Mill City 25 09S I2E 1400 Description of personal property Date of damage Cause of damage 09/08120 0 Fire(attach fire department report) ®Act of God(describe): Beachie Creek Fire Damage occurred to 0 Land El Building 0 Personal property 0 Manufactured structure Describe damage Entire operation destroyed by the fire.Including buildings, machinery,supplies and inventory. , Application for proration of tax IM I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted within 60 days of damage or June 30,whichever is later. Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my property is only dam- aged,I must notify the tax collector of the date that the damage is repaired.Such notice will serve to inform the tax collector of their duty to calculate and finalize the tax proration. Declaration -- I declare under the penalties for false swearing[ORS 305.990(4)]that I have examined this document and to the best of my knowledge it is true rrec`and co lete. A � �� / -020ppli nYs signature Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only il Date received: Z-if'-2 I Clerk: Fr Date received: � ,p I/7Clerk: Z flif Damaged property: Z / 0 2,p This year Land and improvements:...--s Date rebuild complete: ENS'oaths r ?(ta Real ctmarket value( 1 a i RMV after / G jfC-e►+"�- fire/act of God: 6��j �(D fire/act of God: Zf)gr 7�� ADSo 1 TO VP' Assessed value(Ala i�,efQreZ b Value rl fire/act of God: 1 S Destroyed propegto percent of loss: O CH This year Personal property; Months prorated: RMV before RMV after fire/act of God: fire/act of God: Amount of adjustment/refund:I AV before Value fire/act of God: percent of loss: Remarks: Date property visited: I Z/3)ZoZO 0 Damaged 0 Destroyed 1_Aia.D -oA/Ly Arc uAir 150-310-083(Rev.12-15)