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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 OTC —14i671 <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 namePhone <br /> E/vin • 581,44, X03 -5io — 73// <br /> Mailing address Email(optional) <br /> o _ a !✓e_. VoAbiczh ©ymc_1 1. cm„ <br /> Va eS OA_ Solt- 97341 <br /> 1 Location and description of damaged or destroyed property <br /> Assessor's account numbe <br /> 555758 (number_ <br /> 555758 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 33713 Railroad Ave SE 25DC 09S 3E 2600 <br /> Description of personal property <br /> Gates, OR 97346 <br /> Date of damage Cause of damage <br /> 7-1 09 og, Q, p E 'Fire(attach fire department report) ftrAct of God(describe): f--ir-e 4 1,lJ,fn s 5 '"forw\ <br /> Damage occurred to <br /> [Eland p Building la'Personal property ❑Manufactured structure <br /> Describe damage <br /> 1 <br /> NovstiQ I S PU.w-p [Oust a II birokti) x01, ycl <br /> 0 0 <br /> W Zo <br /> Application for proration of tax > (" 4 0 cn <br /> Ild'1 am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must sub2tted Z w <br /> within 60 days of damage or June 30,whichever is later. a O Co <br /> Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my props orVam-Q Q <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 to calculate 2 <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 C 4--c; /6° Q�,e... -.._ 07— /7 moa 6 <br /> Applicant's 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 property: This year Personal property: <br /> Months prorated: 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 ❑Destroyed <br /> 150-310-083(Rev.12-15) <br />