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Ai <br /> Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date received <br /> Oregon Revised Statutes(ORS)308.425 <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 /> Ap ant's name <br /> kat e 0 GL, a 'to t 0 h a r'I 1arut. e L''I Phgs/ - s3/ 31,go <br /> Mail aDddress mail(optional) <br /> O <br /> Ci ` � ,b rung IQ. y10)0 <br /> J 1„ State ZIP ode <br /> `� o 93 V 7— <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> M129271 / 129271 <br /> Location of property(if different from above) Section Township Flange Tax lot number <br /> 150 Butte St N 01 BC 10S 5E 5100 <br /> Description of personal property <br /> Detroit, OR 97345 <br /> Date o damage Cause of damage �� ( /f-\49 g'/ � 7 // <br /> O 0 Fire(attach fire department report) XCAct of God(describe): tall l Cl ( j r'e...- <br /> Da ge occurred to <br /> 0 Land 0 Building 0 Personal property 0 Manufactured structure <br /> Describe damage <br /> x1-61 t L Ss O.0 a[( SivIke u.nts Qal --4ry CS- <br /> Application <br /> sApplication for proration of tax <br /> I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application `"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 deter y pr�krtg)% Ily 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 coil ctor of`tr t to calculate <br /> and finalize the tax proration. \al �0\P\-\ <br /> P\` <br /> cl <br /> 04 SC) <br /> ANO fr <br /> Declaration p. <br /> I declare under the penalties for false swearing[ORS 305.990(4)]that I ve examined this document and to the best of my knowledge <br /> it is e,c rr:.- ,and complete. j, <br /> Applican s signatureJo. /0/5//2,0 2-0 <br /> 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: I-14-21 Clerk:/' ' Date received: 121 01/ZOOO Clerk: Z 7-4 y <br /> Damaged property: This year Land and improvements: <br /> Date rebuild complete: Months prorated: Real market value(R1vly)betoxe RMV after <br /> fire/act of God: 76,1 V fire/act of God: <br /> Assessed value(AV)b f e QValue p <br /> Amount of adjustment/refund: fire/act of God: , /90 percent of loss: I 00 /� <br /> Destroyed property: a This year Personal property: <br /> Months prorated: 1 RMV before RMV after <br /> fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/$: -- 3$0'S fire/act of God: <br /> percent of loss: <br /> Remarks: Date property visited: 1'Z/01/Z-020 ❑Damaged ADestroyed <br /> 150-310-083(Rev.12-15) <br /> i3 <br />