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� S <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 <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 name <br /> Phone <br /> Steven Beireis 541-220-1335 <br /> Mailing address Email(optional) <br /> 431 Hill St SE s.beireis@comcast.net <br /> City State ZIP code <br /> Albany OR 97321 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> lar -898569 mobile home-M323781 2 x`18( <br /> Location of property f ff different from above) Section Township Range Tax lot number <br /> 180 Clifford Ave <br /> Detroit, OR 97342 Description of personal property <br /> land and double wide mobile home <br /> Date of damage Cause of damage <br /> 9-8-2020 OO Fire(attach fire department report) IDAct of God(describe): Lionshead Fire(Santiam Canyon) <br /> Damage occurred to <br /> tE Land 0 Building l]Personal property I 1 Manufactured structure <br /> Describe damage <br /> Multiple trees destroyed by the fire. Double wide mobile home and contents completely destroyed, burned to the ground, <br /> nothing left to salvage.We are unsure of the date home will be replaced, it may a year or two from 2020. Land will start <br /> recovering in spring of 2021. <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.Applicatio ust gasut <br /> within 60 days of damage or June 30,whichever is later. <br /> N O=O <br /> Whether my property is damaged or destroyed will be determined by the County Assessor's office.if the assessor determines ..-i i is orQ9�n- <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 It -'r.7 to deciifite <br /> and finalize the tax proration. W f� <br /> O koS <br /> Q O Q ¢ <br /> z <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 /> Applicant's signature / ( �� <br /> 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: 11-7:1-20 Clerk:/ Date received: 1 1l2v/Zo7.p Clerk: Z7 <br /> Damaged property: This year Land and imams: <br /> Real market valueRMS)b ore RMV after <br /> Date rebuild complete: Months prorated: fire/act of God: (2L S, 73d fire/act of God: <br /> fi <br /> Assessed value(AV)befcle Value A <br /> Amount of adjpstment/refund: fire/act of God: 17,7(0 percent of loss: 100/ <br /> Destroyed property: This year Personal property: <br /> Months prorated: / RMV before RMV after <br /> fire/act of God: fire/act of God: <br /> `35 AV before Value <br /> C^ <br /> Amount of adjust fund: l L fire/act of God: percent of loss: <br /> Remarks: """.- Date property visited: I I/7-0/202.0 0 Damaged Destroyed <br />