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Request for Appraisal Review Office Use Only <br /> Taxpayer please fill out this side only <br /> Date: II Log#. / Ii ( / <br /> /i }(2/ <br /> Filing Deadline is the first Friday in December <br /> Taken by: oT(- <br /> Please use separate review sheets for each account <br /> CC 05 <br /> Date: Jr'l7 -zu zi <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes cr No an, V 14s_ <br /> Review Requested By(if different than property owner): <br /> Owner Name: /be,^ I CC "95 Email: 7/r,ExP" Phone: rj09(13 <br /> Owner Mailing Address(complete address): <br /> ": •; / �/ P- � - 5 — 992Y55---- <br /> Street <br /> i AzCStreet Address of Property for Review: }^ 1/ City: <br /> Map/raxlot#: Account No.: 35-7657� <br /> Real Market Value Requested: <br /> 0 O <br /> -- <br /> Land: Structures: Total: f7 L SIC, <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> --e.- <br /> nu ' L. <br /> ti <br /> 3 y / C I' ��c _ / t L, C— 3L-,, o cd �d 01 zciys�om <br /> i IS9Q4br <br /> s 2� <br /> 5.5 11-171-by <br /> �r �7 100 <br /> iv 7u., ktC 359 03 3 .S49ilr9s4 <br /> ;:i4/47)/(-7 <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.or.us/CO/Pages/bopta.aspx <br />