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I (' I i'n i I-or ni .. y Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God Date received Oregon Revised Statutes(ORS)308.425 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. Ap Icant's name — ;i+ra 4- v P971.252-225! Mailing a cess p iv,, box, t ?� ail(optional) -jppp,,, /j' City �xlJ L / i % I��/� k , lib .7,2, 13 Location and description of damaged or destroyed property ' Assessor's account number R X153 s�( s� V\.. co Location of property(if different fromabi 4Yt Section Township Range� �1Jt Tax lot number 54141 T 10r M. .--, c t�-►5 A ,3oul� zea �w Cl2 157 Description of personal property 4(15 . c'7 SS en-I-ir?.:rz.�c tA.lfl[vi mita-bud -, ge Cause of damage[/1/ , i (\�J y I � - ) p--1.--;(1k;: ,,‘, ❑Fire(attach fir de 11m"elft repovrt) ►7,Act of God(describe): A 1 I It i -� ►(- Mt 1 j\ Damage occurred to ;�t� Land ,B'guilding 1ersonal property 0 Manufac ufebs.�Lrcture --k.(2.12A-14- . ribe damage a kVOW )inn' oubr--5 c. u rh' $ 74 c t Q Aw .weN i, r wort CO la-, c -fr I % t A, (I 0 l�o�rr� . v)(Adg-�,ts oki4j , ' t •20 e uu.) o u?e.6 a.cc e, ' o in ,i-24 (A)v - Application for proration of tax T---- ---------- i(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 prope ' 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 d calfflate I-- and finalize the tax proration. Z cc — oil) Z W _ 0vQnDeclaration IL I declare under the penalties for false swearing [ORS 305.990(4))that I have examined this document and to the best of miiowEitge § it is true,correct,and com.lete. X Applican s signature A- �� 9 '�� 010 d() Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: I-Z7-Z I Clerk:/Ir. Date received: JO a/. �J Clerk: kit/ b Damaged property: This year Land and improvements: Date rebuild complete: Months r N`i Real market value RMV)before RMV after p �,\ °irME �Tel V NTfire/act of God: 47i; fire/act of God: I D 1 c c 07 QVAssessed value(A efore �" Value �{�ti _ fire/act of God:— ('�1 percent of loss: Q— Destroyed property: No F►[��+� 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: fire/act of God: percent of loss: Remarks: r<-0 Date property visited: if)v2,; 0 Damaged stroyed ....O....'---- 150-310-083(Rev.12.15) --