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OTC-= <br /> Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date eceived <br /> Oregon Revised Statutes(ORS)308.425 i t - "5-- 7<'2c_: <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 /> Appli is name x Phone <br /> Yo-onid. CRea, iLl t- ( Z rz. tee,... '`5b3 19( -774a <br /> Mai ing address Email(optionpl) cm-dt <br /> Ci ode <br /> ty StateZ1(112$ti,, <br /> ��")CXSt fL4 c Location and description of damaged or destroyed property <br /> Assessor's account number �J <br /> 'R41716 / 541716 I'll ` (29 4 ( ( Z 2L C1P <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 630 North Santiam Hwy pl7 3 Q q 3E o/c/OO <br /> Description of personal property • <br /> Gates, OR <br /> ('d ML L7 J(Oi- <br /> Date of damse Cause of damage � ('� <br /> CI � D Fire(attach fire department report) N i ct of God(describe):QZ 3i) �.!d 1 .-5 <br /> Damage occ rred to � <br /> RI.and Enuilding C1Personal property &I anufactured structure <br /> Describe damage r 1. <br /> Au �4�e� ` p- 5, i pLop sd1 , q(, o 1 r1 t r a 5 12��s 4 /-/ 4 1 L <br /> Ali ciAQL4-1.6( 4 <br /> Application for proration of tax <br /> LV1 I am 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 tr,orrect,an complete. <br /> X t iI /6/,2C <br /> Applin is 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: (2-30-20 Clerk: /if Date received: }, _ 1-a O Clerk: wV 0 b <br /> Damaged property: This year Land and improvements: <br /> Real market value(RM liwfoce,.., RMV after <br /> Date rebuild complete: Months prorated: ' fire/act of God: `i fire/act of God: 0 <br /> Assessed value(AV)before „ Value <br /> Amount of adjustment/refund: ----- fire/act of God: 1 e y' percent of loss: 1_i b <br /> Destroyed property: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: 7 - fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustmen refund: ` as-'75 fire/act of God: percent of loss: <br /> Remarks: ( - Date property visited: IR./(1-4;2 0 Damaged /Destroyed <br /> cYb rl` Q..1Y [r r7 Wim”. // <br /> 150-31D-083(Rev.12-15) <br />