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Application for Proration of Property Taxes For county use only <br /> received <br /> Due to Damage by Fire or Act of God Date <br /> Oregon Revised Statutes(ORS)308.425 <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 July1 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 Phone <br /> John R Marks 5037508232 <br /> Mating address Email(optional) <br /> 283 Eider Ave.SE jmarks1243@comcast.net <br /> City State ZIP code <br /> Salem OR 97306-3414 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> 547055 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 11028 Dogwood Ln SE, Lyons, OR 18 9S 3E 800 <br /> Description of personal property <br /> Four buildings and contents of second home. <br /> Date of damage Cause of damage forest fire <br /> 9-8-20 ❑Fire(attach fire department report) Z Act of God(describe): <br /> Damage occurred to <br /> 0 Land 0 Building 0 Personal property 0 Manufactured structure Q <br /> Ili N E. <br /> Describe damage LO Z O <br /> Complete loss due to forest fire. >Iracvcc <br /> 0 z <br /> aco <br /> Application for proration of tax Q; Cr) c `c <br /> 0 I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submid <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 ,2 9-14-20 <br /> is signature Date <br /> —Applicant will be notified of the county's decision— <br /> For tax 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: fire/act 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 properly: This year Personal property: <br /> Monthsprorated: RMV before RMV after <br /> 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: 0 Damaged 0 Destroyed <br /> 150-310-083(Rev.12-15) <br />