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• eaVE Application for Proration of Property Taxes For coouuiiR'y ube Duly D Due to Damage by Fire or Act of God Date received Oregon Revised Statutes(ORS)308.425 MAR 01 2021 Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this nMAkkati iiI ft of tax due or result in a tax refund.The tax year is from July 1 to June 30. TAX COLLECTOR •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. •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name Phone John Aschenbrenner (907) 306-2194 Mailing address Email(optional) PO Box 671521johnaschenbrenner63@gmail.com @gmail.com City State ZIP code Chugiak Alaska 99567 Location and description of damaged or destroyed property Assessor's account number R61922 / 561922 Location of property(if different from above) Section Township Range Tax lot number 23467 Santiam Way SE 17AB 09S 2E 1600 Description of personal property Lyons, OR 97358 Date of damage Cause of damage September 8, 2020 ❑Fire(attach fire department report) 0 Act of God(describe): Beachie Creek Fire Damage occurred to El Land 0 Building El Personal property ❑Manufactured structure Describe damage Our family cabin burned to the ground. Application for proration of tax 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 tr ,correct,and complete. .�. /., 242 ( Appli.<nt signatur-' late —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: 3_14/ Clerk: Date received: ct .0%-cl, ( Clerk: 4)1/ Q(p Damaged property: This year Land and improvements: Date rebuild complete: ...� Month j jE Real ctmof God:et value 17 3 0bBre RMV after �000 �0��(l7 fire/act of !%a O 0 fire/act of God: / pD, E� Y1►�. Assessed value(AV)before Value d n i�io fire/act of God: 7 02�n percent of loss: Destroyed proper f+l 1r This year Personal property: r1V MonthsRMV before RMV after prorated: fire/act of God: fire/act of God: AV before Value Amdu It mf 8tijdstment/refurid: fire/act of God: percent of loss: Remarks: Date property visited:A- -(# '1( 0 Damaged/Destroyed CISPYyk- C rmc� / 150-310-083(Rev.12-15)