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0,-1 _,,LD ie-t- <br /> Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date received <br /> Oregon Revised Statutes(ORS)308.425 A_ (14- Zc `e.- <br /> instructions: <br /> •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 <br /> of tax due or result in a tax refund.The tax year is from July 1 to June 30. <br /> •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. <br /> •File your application with the county tax collector of the county in which your damaged property is located. <br /> Applicant's name <br /> David Phelps Phone <br /> Mailing address 503-559-8306 <br /> PO Box 359 Email(optional) <br /> City djphelps1@mac.com <br /> Lyons State ZIP code <br /> OR 97358 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> !Z t-{1 oS to <br /> Location of property(if different from above) Section <br /> 11034 Dogwood LN SE Township Range Tax lot number <br /> Lyons OR 97358 Description of personal property <br /> Date of damageCause of damage <br /> 2020-09-08 ) I Fire(attach fire department report) E Act of God(describe): Wild Fires <br /> Damage occurred to <br /> Land El Building 0 Personal property ❑Manufactured structure <br /> Describe damage Q <br /> G Z cc <br /> All structures on the property were destroyed by the fire, no structure is left. LL O <br /> Ncn <br /> I, ' d' v Ow <br /> ,••i Z u) <br /> V O co <br /> Application forP <br /> proration of tax c cn i <br /> El I am applying to have the above property examined for proration of property taxes per ORS 308.425. Application must be submitted <br /> within 60 days of damage or June 30,whichever is later. <br /> 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- <br /> 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 <br /> and finalize the tax proration. <br /> Declaration <br /> I declare under the penalties for false swearing[ORS 305.990(4)]that I have examined this document and to the best of my knowledge <br /> it is true,correct,and complete. <br /> X , '` 2020-09-14 <br /> Applicant's signature <br /> _____ Date <br /> —Applicant will be notified of the county's decision— <br /> For tax collector's use only For assessor's use only <br /> i <br /> Date received: Clerk: Date received: <br /> Damaged property: Clerk: <br /> This year Land and improvements: <br /> Date rebuild complete: Months prorated:_ Real market value(RMV)before RMV after <br /> fire/act of God:—_ fire/act of God: t <br /> Amount of adjustment/refund:I Assessed value(AV)before Value <br /> Destroyedproperty: fire/act of God: percent of loss: <br /> y This year Personal property: <br /> Months prorated: RMV before RMV after <br /> fire/act of God: fire/act of God: f <br /> AV before Value <br /> Amount of adjustment/refund:I <br /> fire/act of God: percent of loss: s <br /> Remarks: <br /> Date property visited: _ 0 Damaged 0 Destroyed <br /> i <br /> r <br /> s <br /> 150-310-083(Rev 12-15) - € <br /> `s <br /> I <br /> f <br /> I <br /> t; <br /> P <br />