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Application for Proration of Property Taxes For wordy use only Due to Damage byFire or Act of God °ate` Ned Oregon Revised Statutes(ORS)308.425 Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction.if approved,this may reduce the amount of tax due or result in a tax refund.The tax year is from July 1 to June 30. •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 Kaufman,Gary L and Sue (503)871-6024 Marling address Erna(optional) 8900 Deschutes Rd SE sugar8900@earthlinknet City State ZIP code Salem OR 97317 Location and description of damaged or destroyed property Assessor's account number R59181 Location of property#different from above) Section Township Range Tax lot number 11661 Riverwood Dr SE Lyons ,,fDe9 inion of personal 541Pr°PeilleVU24‘1)14 Dade of damage Cause of damage Sept 8,2020 0 Fire(attach fire department report) ❑Act of God(describe): Damage occurred to 0 Land 0 Building 0 Personal property 0 Manufactured structure Describe damage Builthngs and property totally destroyed by Beachie Creek fire: 2 buildings,deck,stairway to river,landscape plants W N z p� N OO Application for proration of tax 1-1 cc W I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application mi be •1.mit within 6d days of damage or.Hone 30,whichever is later. Ix cn <4 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 t have examined this document and to the best of my knowledge it is true, ,and complete. X 0:4 4.<0 15 Sept 2020 Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: Cleric: Date received: Cleric Damaged property- This year Land and improvements: Date rebuild complete: Months prorated: Real market value(RMV)before RMV after fire/act of God: fire/act of God: Assessed value(AV)before Value Amount of adjustment/refund: fire/act of God: percent of loss: Destroyed proper This year Personal property: RMV before RMV after Months prorated: firelact of God: fire/act of God: AV before Value Amount of adjustment/refund: fire/act of God: percent of loss: Remarks: Date property visited: 0 Damaged ❑Destroyed 150-310-083(Rev.12-15)