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c • RECEIVED Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God Date recely? OV 9 2020 Oregon Revised Statutes(ORS)308.425 Instructions: Application forproration of propertyMARION COUNTY • taxes may be made for the tax year of the property damage/destruction.If approved,this rt yvegnt 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 Phone Mailing ad a Vitt° li' e/ /�{ 1 Do & 1 5 D.3—`�Q 9 ' h 2 r,"�a cS a / es 8c; C, Email(o ti nal) City c/ J_ cl c ��o �b tiOt�i a gr (a fcs State Igi 3 G Location and description of damaged or destroyed property Assessor's account number 5L /1 .5-g' k2--`tll E Location of property(if different from above) Section P �/ Towns9hips Ran�/�4..... I Tax lonum bVr- ap Jqn L2j g' 8n—ObDD [ Descripton of personal property Date ofd age Cause of damage / .D., t c. F 2U Z0 I 0 Fire(attach fire department report) . Act of God(describe): W/fO� �(''..e. Damage occurred to Land , -Building 0 Personal property 0 Manufactured structure Describe dams e w/ ld .cf' des1i"ye hu / /d%65 at, ,P� Covlftjr/1s f 20 lci,_ 74 eG' 7 ✓,f� lC� r ' V ©6c 5 (o0 j * "t'lr'Sf S ' ''tk� T4nhc(• �j) SC��cr� Oct," 4...,--74-5" �(cc. T i,Cc 1��1'✓ Application for proration of tax J4I am applying to have the above roe ` property rty examined for proration of property taxes per ORS 308.425.Application TA, sub • within 60 days of damage or June 30,whichever is later. t ‘C) d1/4 Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my prop- a am- 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 th i.‘I 04, • •and finalize the tax proration. alculate 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 tru , rrect,and complete. X '� i/,xe� -7 Applica 's signature p� D GCJ 2 C`D Date —Applicant will be notified of the county's decision— For tax collector's use onl y For assessor's use only Date received: /t, -2..a Clerk:fil Date received: - Damaged properly: >/'��' Clerk: �() /� r This year Land and improvements: Date rebuild complete: Months Y Real market value(RMV)before RMV after �j�C !y� 1000.1 EN'S.�� , itAOUN� fire/act of God: 9,6',$.3 4 fire/act of God: O2 O U fV Assessed value(AV)before Value a t�' fire/act of God: 3 49 I O Destroyed propertyi3O^Vrw_ Thu�1N �_ percent of loss: is year Personal property: Months prorated: RMV before RMV after fire/act of God: fire/act of God: Amount of adjustmenVrefund:I AV before Value fire/act of God: percent of loss: Remarks: , r �� B -J,,{'j Date property visited: loj-2 ,, t 2 ❑Damaged Destroyed 150-310-083(Rev.12-15) • i