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(7C c(J <br /> Application for Proration of Property Taxes For county use only <br /> Date received <br /> Due to Damage by Fire or Act of God <br /> Oregon Revised Statutes(ORS)308.425 I 12_ <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 Phone <br /> G es32.GEt►�.�_e-c L� Ebb -339 - 2g8 <br /> Mailing address Email(optional) <br /> City State ZIP code <br /> e(L Q1 Sac, <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> Ca l (C ( <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 32 3(b S 03C\9aci <br /> Description of personal property <br /> Date of damage Cause of damage O I`C3 <br /> 20 Co 0 Fire(attach fire department report) Act of God (describe):� .h0k4S_E. ectsr .fe. Wim')c' <br /> Damage occurred to <br /> NCand 0 Building 0 Personal property 0 Manufactured structure <br /> Describe damage <br /> A.L.& CRF--a 0,L)'-'j C3 J v'Y4-1C5 e20?EA-C-1 r-LL (coo , O Esc 2;a ED Q u E <br /> AZ) .it1tF %Eacla e &Era K w.+L0 F .e a <br /> (ID,< t7, 2 0 Z <br /> Application for proration of tax <br /> Tm applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> within 60 days of damage or June 30,whichever is later. <br /> 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- <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 of their duty to calculate <br /> and finalize the tax proration. <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 /> X - V- {Qcl ( ,y11_0 .0 <br /> Applicant's signature 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: Clerk: Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Real market value(RMV)before RMV after <br /> Date rebuild complete: Months prorated: fire/act of God: fire/act of God: <br /> Assessed value(AV)before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Destroyed property: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Remarks: Date property visited: 0 Damaged 0 Destroyed <br /> 150-310-083(Rev.12-15) <br />