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c Q <br /> Application for Proration of Property Taxes For county use envy <br /> Due to Damage by Fire or Act of God Date For <br /> Oregon Revised Statutes(ORS)308.425 q-2$3- <br /> Instructions: <br /> •Application for proration of property taxes may be made for the tax year of the property camage/destructon.If approved,this may reduce the amount <br /> of tax due or result in a tax refund.The tax year is from Jury 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 damage()property is located. <br /> A„D cant s-tame _.. Phone <br /> Signy G.Erickson 541-410-5445 <br /> Ma,ng address <br /> I Emz.'.lopsonaq <br /> PO Box 8488 SignyE@aol.com <br /> City Crate Z P cope <br /> Bend OR 97708 <br /> Location and description of damaged or destroyed property <br /> Assessor's accoun-number <br /> R42151 _ 1(51 <br /> Locator of property if afferent from above; Section 'Towns_p i Range [Tax or ncmoer <br /> CZin S Gre Lof 2-CaO Z06a I LR3 i `I 1 1 DCte�f <br /> Descr+pr on of personal property <br /> r— Vacation cabin and belongings <br /> Date of damage h CaJse of damage <br /> 9-2020 'il Fire(attach fire department report) ii Act of God(describe): <br /> ----- ------ ---------------------- <br /> Damage occurred to _.----- -- <br /> Land Building *'Personal property a Manufactured structure <br /> Dewe De damage <br /> Lionshead Fire-cabin burnt to the ground-viewed from drone photo <br /> --- ---- ---- — -- <br /> Application for proration 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 w II be determined by the County Assessor's office.I'the assessor determines my property s only clan.- <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'tnalize 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,ap4-pomplete. <br /> ' 9-23-2020 <br /> Apr, a n's s r at re Data <br /> A plicant will be notified of the county's decision— <br /> For tax collector's use only For assessor's use only <br /> Date recervcd. 42_1-.26 Clerk: /'a' Date received TO Clerk: Q <br /> Damaged a9 property: This year Land and improvements: <br /> ^ j Real market sal (JP�VI f re RMV atter 0 <br /> ✓✓ <br /> Date reb :c complete -__ Months prorated. f,e rapt of God: .e firelacr of Sod- <br /> Assessed value(AV)before Value J� <br /> Amount of adi..:stirennefued�j ^ tre act of God: 2_,. percent of loss: J.�/ <br /> Destro ..___._.. <br /> y propert6.y: This year Personal property: <br /> RMV before RMV atter <br /> Months prorates: Ire'act of God: firm./act of God <br /> AV oefore Value <br /> Amount of adicstme 'refund 2 72.77 1'e-act of God: , J'•'�percent of loss. <br /> Remarks --_---- Date property visited/Q_•44 zJE Damaged �'Kestroyed <br />