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Request for Appraisal Review Office Use Only <br /> Log N: l - oaS <br /> Taxpayer please fill out this side only 22-14 <br /> Date /0 - <br /> Filing Deadline is the first Friday in December <br /> Taken by: ora DOZ <br /> Please use separate review sheets for each account <br /> Date: /0 .22 21 <br /> VC <br /> "„- <br /> ��, <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes QNo til Sr <br /> Review Requested By(if different than property owner): <br /> Owner Name: vLy �"J 'se r n"A`-- Email: Phone: g()frd(oc-d- 1 <br /> Owner Mailing Address(complete address): <br /> Street Address of Property for Review: /gfq-/y I ceN td-0}r �11'/ City: <br /> fS 2/ a <br /> Map/ axlot#: Account No.: ) y <br /> Real Market Value Requested: <br /> Land: Structures: S-OoD Total: 4ir006 <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> Ro, 4 s4,U Lead, S, nK, <br /> si Wlp/ e L• t) (Md, An ltw.1/ a'o- w,‘1061.0 <br /> her, Vdw t> }De Nlyb 4/ ) 972 ,n b1.Lt Hvee <br /> Please email completed forms to: assessor@co.marion.or.us <br /> You may also print and mail copies of completed forms to: <br /> Marion County Assessor <br /> P.O.Box 14500 <br /> Salem,OR 97309 <br /> THIS IS NOT AN APPEAL <br /> Please refer to appeal rights included with your tax statement. <br /> To file an appeal please visit: <br /> http://www.co.marion.orus/CO/Pages/bopta.aspx <br />