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Request for Appraisal Review Office Use Only <br /> Log#: _1 ' nq <br /> Taxpayer please fill out this side only <br /> Date: iiff2. <br /> Filing Deadline is the first Friday in December <br /> Taken by: L`so . i 7 <br /> Please use separate review sheets for each account <br /> Date: NOV. 3 ?la1 Pe <br /> sr ,t6'il4 <br /> Have you appealed to the Board of Property Tax Appeals?: C Yes �rvO <br /> Review Requested By(if different than property owner): <br /> LFw;�S tZ T 5 ')/ P7 775/ <br /> Owner Name: L)wpfl K 6rn., OLE-5 Email: TEF)5 LE10i0Hoo,cob.Phone: CI 70... 7 7 <br /> Owner Mailing Address(complete address): <br /> I .Q1S5 r2Fs�AVE ST. Wrvi T Z IQ ‘, s I L Vr-2 toy, Ot 9 7 <br /> Street Address of Property for Review: 13 45 (ZE Si:R V E ST. ui NIT .210 City: c.l LVL R 'f ori) <br /> Map/Taxlot#: Account No.: 0017 780 f1 O 600773 <br /> Real Market Value Requested: <br /> ( Q <br /> Land: Structures: Total: .3t11 t3� V <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> T'FI� fIzo'r_ri1 Vv65 'UI ( Hf15F) c'N 01 30,7c2o 4-0P if-52 7/ Gav <br /> 1.+F_ ' CHr'e jIcE INGIuU*6 130Tff 7 f1e Rome AND THE.. 7+it <br /> 6 wn6r A10T f�7iPc1-t .1 TO ll�t= MOUSE. HOWU . <br /> we ���� 1141- ST� ErnFt1i6 i.-lowA-UkR ONE- rc, 7 <br /> a 0" C-SS 0 T 4-77231 , 3D OA) flN )ISP .fo R Tff & <br /> 66R6 f0R 0 6D , ly <br /> $N Tµ I N K t r\ E G P RM 'T Fi Th 1r ruT WFC 1) /V , 7 f-I1 <br /> Ho u'i F ) F 5 F uomi ft 5 ik, ) N c l ui Wb T - G-fi T< P+63e <br /> Nit' Tf fr Fi«T +* 6QD7Sv <br /> GFRNi-F TP y I CCT °D7 <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.or.us/CO/Pages/bopta.aspx <br /> 5(�►l!D O I(\\ C,�S t� <br />