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e .. KJ- <br /> Application for Proration of Property Taxes For county use only ' <br /> Due to Damage by Fire or Act of God Dare received <br /> Oregon Revised Statutes (ORS)308.425 - (p-,.�Zo <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 mast 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 f PhcnP <br /> Roger D and Pamela A Bristol :541-554-8932 <br /> Mailing address Email(optional) <br /> 31166 Territorial Dr pbnanapam@gmail.com <br /> City State ZIP Code <br /> Harrisburg OR 97446 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> R47059 / 5 (t-1(2)-5 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 11048 Dogwood Ln SE 093E 18AB 01000 <br /> I Description of pe,sonal property <br /> Lyons, OR 97358 <br /> Date of damage I Cause of damage <br /> 9/8/20 E Fire(attach fire department report) 0 Act of God (describe): <br /> Damage occurred to <br /> O Land C Building O Personal property Li Manufactured structure <br /> Describe damage <br /> From pictures taken after the wildfire we have been sent it looks to be totally destroyed. We are still unable to go up and <br /> inspect <br /> Application for proration of tax <br /> 0 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)1 that I have examined this document and to the best of my knowledge <br /> it is true,correct,and complete. / <br /> X <br /> 9/14/2020 <br /> Applica si ature i, �/// Date <br /> —Applicant will be notified of the county's decision <br /> Fortax collector's use only For assessor's use only <br /> Date received: Clerk: Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Real market value(RMV)before RMV after <br /> Date rebuild complete: _ Months prorated: firelact of God: fire/act of God: <br /> Assessed value(AV)before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Destroyed property: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Remarks: Date property visited: ❑Damaged ❑Destroyed <br /> 150-310-063(Rev_12-'51 <br />