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Request for Appraisal Review Office Use Only <br /> Log k: T2I - p5fl <br /> Taxpayer please fill out this side only <br /> Date: <br /> Filing Deadline is thefirst Friday in December ^ CAdd'� #9,y <br /> Taken by: �u <br /> Please use separate review sheets for each account <br /> res. -#9y <br /> Date: 12-h/21 <br /> rlr <br /> Have you appealed to the Board of Property Tax Appeals?: C Yes @No V ' Q.e:: <br /> Review Requested By(if different than property owner): <br /> nil <br /> amp It <br /> Owner Name: 1)A0(9,-,30 6ry tck Email: Jbo(k.6 Alta.c7 ' Phone:Bole $`H-7301 <br /> Owner Mailing Address(complete address): <br /> 1255 ry e %rte)j) n i+ 130, S`I )y-e.rtb-n d(. 9753 I <br /> Street Address of Property for Review: SLI 4 j4, t,-L2 r-,.)--(.. City: <br /> Map/Taxlot k: 0621W;SA L,DD Dunt No.: .1# r 600 /-7 7( <br /> Real Market Value Requested: �n <br /> Land: Structures: S Jaye" Total: 3 (C6,CA3 <br /> Please provide additional information and documentation supporting <br /> sup orting your requested value.Attach additional documents if�ecessary.�GYkk005 flua � W 40 c_ j74-AV0.,„ <br /> Jn�ln2d <br /> aa- Se 3S&, ooz.Do <br /> ' ktfic re 1 G.m rtofi S°re U9 ' ayes SL.otAJ "`^J' <br /> Ick crwv2 tr QLt- tr399) -i-- 57P , q7b ,,-y <br /> 6 cis 1i . <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 10500 <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 /> httpl/www.co.marion.or.us/CO/Pages/bopta.aspx <br />