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Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God Date receved Oregon Revised Statutes(ORS)308.425 - ZL Instructions: •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 of tax due or result in a tax refund.The tax year is from July 1 to June 30. •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. •File your application with the county tax collector of the county in which your damaged property is located. ----------------------- Applicant's name Phone //67/ eI Chr ls�-i•nr, Kph Yor i Mailrg address II Email(optional) S E -fY K 11!-e Co n City 1 Q Stat � )zip...,..?dek---y is Location and description of damaged or destroyed property Assessor's account numberc o i Cg I o ' ) '7/ nalCO Location of property(if different from above) Section Townshi Ran e V ax lot number S IBBA oil Io i- r~=1dgA(ZAo Description of personal property Date f damaR Cause f damage - ' IlE•cire(attach fire department report) D Act of God(describe): Dam Land ,tf�,/Persurred to/ �`.a„t-(and / ,L'_7 tLiullding onal property ❑Manufactured structure Descldamage cls e c, t- r r e d,QS 1 y e c ,� k 0 ✓Y) •e e fr Sa- I c 0._pi cd o v -Sl•J e c4-v e Application for proration of tax I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted within 60 days of damage or June 30,whichever is later. 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- 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 and finalize the tax proration. — Declaration 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 it is true,corr t,and complete. Appl . ignature Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: l/..z7.1 b Clerk: /z" Date received: i O 3•2.46 Clerk: V4 V Pco Damaged property: This year Land and improvements: Real market valu otxt aefor5 RMV after �^ Date rebuild complete:_ _._ Months prorated: fire/act of God: AZO fire/act of God: Z3+55d Assessed value(AV)beforeValue Amount of adjustment/refund: — fire/act of God:1 11p-19^\V percent of loss: O Destroyed property: This year Personal property: Months prorated: � RMV before RMV after fire/act of God: fire/act of God: AV before Value Amount of adjustment/refund: "'o— fire/act of God: percent of loss: Remarks: Date property visited:to'lel 2 C) 0 Damaged estroyed Oalik9 e/ rrr&A 4V4 Ri1V 150-310-083(Rev.12-15).--- ---