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Application for Proration of Property Taxes For.. use• Due to Damages by Fire or Act of God Gaegeit Revised,motes(OM 308.425 instructions: I I : I I •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 flied within 60 days of the damage or by June 30 of the tax year in which the damage occurred,f C •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name Phone .1 C 4441) 69Le f n Sv3-3fo -7575 Meiling acid7 S D eact,yj fir mate ii,. D. i 1�.p,�,�►,l,a D 4 l 3 Location and description of damaged or destroyed property Assessor's account number LaA t 4l d pro eRy ydilhnnttfiom,aDovep w a' `s p Tax tot nembot iit,4- f d SA-L.1)-44.0 ifl,of' d!..6 of personeiproperty ezip,tid:j. Description Date of damage l Cause�1: / e� 0 Fire(attach fire department report) C!‘of God(describe): 1 F Damage occurred �B�to/ � U Land Luilding IkPersonai property U Manufactured structure Deetxlbs oweOde .•HJ`%e rtadA",1 /ate l/ ' l *404 o Eoar e 1 i3V a-s C(? ?X lav Mil D Application for proration of tax (B'�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 Junes 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 dam is repaired.Such,notice will serve to inform the tax collector of their dusty to calculate and the taut pso aden, Declaration 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 it is true,correct,and compllettee.. Applicant's signature bate —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: /(J-g-ZO clerk:/ Date received: Cleric: Damaged property: This year Land and improvements: Real market value ROAV after Dude rebuild compieae: Months prorated: ''� lire/act of God: ( A Q fs+da of God: fi Assessed vakre AV)before a Value /V(/ Arson t of ad�ad: "-- fire/act of God: 3�, g '?. percent of loss: Destroyed properly: This year Personal property: RMV before RMV after t Months prorated: fire/act of God: fire/act of God: AV before Value Amount Qf lustmfund. 26 5•0 I fire/act of God: percent of loss Date property visited: 0 Da aged Destroyed h AZf s6* �2 -r , �� 14126 u) bra y / 150.310.013(Rev.12-15)