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i <br />' <br /> RFCFIVED <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 SEP 2 8 2�2� <br /> Instructions: <br /> •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this .-•.li,ount <br /> of tax due or result in a tax refund.The tax year is from July 1 to June 30. u.t • <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 nPh•\ev ���L7, _ ,/ <br /> � e t a(` _ <br /> Mailing address <br /> `�� Y Q l <br /> dr, Email(optional) <br /> • <br /> City <br /> ink ekk NkPc State ZIP code <br /> AtekLocation and description of damaged or destroyed property <br /> Assessor's account number <br /> �sci'a--1 5— 556275 <br /> Location of property(if different from above) Section Township Range (Tax lot number <br /> '7-'2-, r1- -k-Wbv-wv Ul9 L, 9-I VA-1 I oq ` ' I 0 )'400 <br /> Description of personal property , A--6C 7K.A.i,' - <br /> (�12� IRuLl1(� C�-Z, 4( �C�dJT <br /> o I <br /> Date of damage Cause of damage &ici. <br /> ' 7.-41-702,0 ❑Fire(attach fire department report) Act of God (describe): C�%e 'E-'k viL_ <br /> tf4Damage occurred to <br /> Land Building 'Personal property 0 Manufactured structure <br /> scribe damage / <br /> .4% tA-. LL kucJ ) ;Mt?UeCiv e, kg\-0__ yrtA.e LA-t.a <br /> 6g.4F)1,,kactiv2i-.a. -5 * ps"--r Ik< <P - , te e__ <br /> \pc-c-A‘e.._ ctro (..,e)t--k vtc--, 1,Q12_ A-:12...-"e-lida tua . <br /> Application for proraticln of tax <br /> 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 swearin ORS 305.990(4)]that I have examined this document and to the best of my knowledge <br /> it is true,coot,a omplete <br /> �� e <br /> X ►►������))... 3 (23 719?_0 <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: 7-24,ZO Clerk: a Date received: /6./3.at, Clerk: 066 Am/ <br /> Damaged property: This year Land and improvements: <br /> Date rebuild complete: <br /> —s .--prorated: `— -- Real market value( M before RMV after <br /> fire/act of God: , '1 6 fire/act of God: I(497,ID <br /> Assessed value(AV) o Value 0 <br /> Amount of adjustment/refund: fire/act of God: ( p7.1aoo percent of loss: . (3 <br /> Destroyed property: This year Personal property: <br /> Months prorated: q RMV before RMV after <br /> fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/4M: 1/0G' 1 f fire/act of God: percent of loss: <br /> Remarks: Date property visited: f 6'I 2.0' 0 Damaged .strayed <br /> ` <br /> 150-310-083(Rev.12-15) <br /> 1 <br />