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RECENED Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God Daterecc 0 9 2020 Oregon Revised Statutes(ORS)308.425 �J Instructions: MARION COUNTY •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this WrQ©(i@jE#eTtatpunt 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 terry lou carlson Larry j crowson 503-569-7674 5 3_ 85/,325 Mailing address Email(optional) 1264 35th ave nw 15a 0--3-4 w0 s-V,w+1 S a=15a l e>1-, q7&)›- t1c2411 aol.com City State ZIP code salem or 97304 Location and description of damaged or destroyed property Assessor's account number R55818 5 S5 g (v Location of property(if different from above) Section M4,' TownshipCCd2 Range Tax lot number 26417 taylor park rd se L.,44::,r1 S 9 7 3S) 092E 11 CD00 p2 Sa eaoa R55818 "/`400 . _`--------------- —--.' CL.ccrinrion:f'w andel p.nrrwArfy summer home trailer/12x12 storage shed/contents Date of damage Cause of damage 9/7/2020 ?Tire(attach fire department report) ] Act of God(describe): . i1 I k ) Damage occurred to I]Land I]Building li Personal property Manufactured structure �j2.0 - "6-2.011,00L-- - 62. iL. '—' • damage /outbilding/decks/stairways/personal property all destroyed due to fire Application for proration of tax 0 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 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 culate and finalize the tax proration. ��! G s - 9�OtiO Declaration Q�.� 0%151-0 OV "� I declare under the penalties for false swearing[ORS 305.990(4)]that I have examined this document and to the best oft; e it is true,correct,and complete. OP Ix X . _ ` -� _ 10/05/2020 Applicant's signa - Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: (0-9:10 Clerk: iP Date received: Clerk: Damaged property: This year Land and improvements: ..----- Real market value(RMV)before RMV after Date rebuild complete: Months pprrora l j fire/act of God: fire/act of God: oat/81614C1° --F� ' �AI• tj sgil Assessed value(AV)before Value ad eli:�t��'� fire/act of God: percent of loss: Destroyed property O 0 This year Personal property: N ---- RMV before /' RMV after Months prorated: fire/act of God: ij y�la fire/act of God: /5-1.4 V/0 AV before �j Value �/ Amount of adjustment/refund: '�"^--. fire/act of God: 7�,ll percent of loss: !/J Remarks: Date property visited: ❑Damaged ❑Destroyed ATO _ 41//0 IA,IA, c,V ft ,71-- /0- 23-2v d R y b4,zr- )ft.,g-MAf :50-310-083(Rev.12-15)