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Application for Proration of Property Taxes FREGEAVElay Due to Damage by Fire or Act of God Date received Oregon Revised Statutes(ORS)308.425 OCT 2 8 2020 Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,thh1A flpce8n-piount of tax due or result in a tax refund.The tax year is from July 1 to June 30. TAX COLLECTOR •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 a r. •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name Phone Nigel Dolder (503)3144749 Mailing address Email(optional) 18649 Old River Dr. redlodn@gmail.com City State ZIP code West Linn OR 97068 Location and description of damaged or destroyed property Assessor's account number 542069 �, �L. (C Location of property(if different from above) Section Township (y9 Range ,+ Tax lot number 34062 Railroad Ave. 30 894E3O }.9& `1rt1 01300 Description of personal property Gates OR 97346 Everything Date of damage Cause of damage Beachie Creek Fire 9/7/2020 El Fire(attach fire department report) 0 Act of God(describe): Damage occurred to 11 Land l7 Building CI Personal property D Manufactured structure Describe damage Complete loss Home, pole building and personal property. Application for proration of tax D 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 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 duty to calculate and finalize the tax proration. 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 complet X / / - 10/20/2020 a Date —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: /0-7 g-2O Clerk:rti Date received: j -fl- 2c) Clerk: O l0 Damaged property: This year Land and improvements: w v Real market value_MV)be_ o RMV after t I C)Q Date rebuild complete: Months prorated: fire/act of God: j/5(� ) fire/act of God: I`1QCJ Assessed value(AV)befsr Value Amount of adjustment/refund: fire/act of God: Z(c 9v percent of loss: O. /�( 5 Destroyed property: or This year Personal property. RMV before RMV after Months prorated: fire/act of God: fire/act of God: AV before Value Amount of adjustmen refund: ' I '7.3/ fire/act of God: percent of loss: Remarks: Date property visited:JLp95 "O 0 Damaged /Destroyed (531 1br r 150-310-083(Rev.12-15)