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1:: ,- ,',,V' <br /> 'n, Clear form <br /> 1 I of 1 RSA <br /> PAge 1 or i,150-soawe <br /> rare Depfar i.nIL C, Revalue FOR ASSESSOR'S USE may <br /> 0 Appruved El Dexieal Fter=vEci <br /> Cfairn for Rebuilt Homestead Special Assessment I <br /> As ormideet by CtapteaSt,Cileauo Laos Al2-1 or•-aeysr.sciloy ii.--.--,--tr2 Li -A. 1-1 h, i <br /> 1 <br /> , <br /> _ 1 <br /> thstrctutiox <br /> RE. <br /> VED <br /> . cwins kr .z,......;1.1 ASSMSVIMIt:lo bem irt ar.125 ur kiter 1...-us must be Ned nth the comity assessor after January 1 and on or <br /> Wore April 1 preceding the tax year or simple,to start.in MS,Vs ctairn tmteeerm Jemmy 2 and Arm I 1,2026). <br /> ren ARI ,U2Ty <br /> . Claims icor spiedalassemeit to begin in.2E121,202,2HTS'.or 2024,must be ti I N ON led on or befote Dee-31,202S, <br /> 2136 N <br /> .kfeiti.":04 hrotion about Itis :tecial.es----,..mt peogram can be found on Poem -firriSA emblntis,15H-7tri-lXil-i <br /> MA <br /> Filed eith tte County Assessor far the tax war beging Juty I',2i3 ____ ASSE )R <br /> Fart A—Owner et information ,•15-aso Fret ortips)- -.- -- <br /> - te <br /> Q _ __Q. NrIl - <br /> : Part B--DeseriPtich of homestead <br /> Fit ti the looms Effrw4 Lo •tow the property'puma-it to lane sioecially assessed Lytle the rebuilt homestead pswai 1. <br /> Property tax=comfit mamba- tittax tax tot,or parcel moot= Homestead sees,..t- <br /> i <br /> I) <br /> 2.,...-.-1 <br /> I. <br /> is the terve:Mead tatirt Mt- • <br /> Is This property lour. 1 . -..trasidereeN.A jets Li no <br /> 2 multi-una&- q? i I <br /> Part C—Elesotiption of special assess,dent quartacation <br /> Qoarelcation criteria: <br /> a Homestead been reed"ries destrWed te.ii reititite betzfeen September 1,MD and September M.2tal: <br /> Is. rses in a county that has ciarrually ailwied tt4sspecinl ESSesairelailk mograat anal the bawdy rieviatetuded init- geogratidsol <br /> artaeovered by a state GT eirit&Heticy deotwatt liT restparse to the wildfire,' <br /> c, the reb,11 hotreStead nepitroos the destroyed homestead on the same IO1Z arid <br /> d. Trtte relealt and destroyed fitatitserd f rust.filEtie tkre simile ortheriA. <br /> Describe both the destroyed and the etbufft below,aad desert, boat the homestead meets aK the <br /> s. t <br /> (-1" eireoeedid4 <br /> *e514tarr ' _ _ r .•11%1—...Ala <br /> ..... a, <br /> - <br /> MIL W.' <br /> :'Nk\...L.• Ilk • Q_N-1,-- <br /> 1111: :> ll.vi.. <br /> fart D—Ueelaratiorr' <br /> /LS cants se the aboiee4W-*/bed groaerly,I acitrehiviedge t iriderrJetHr*pi tarCON•stagvas that troy clitopetly the property liere%odd 1010036- <br /> reprat and that I roust tie an attestation&molly to continue tie special aseasoirreat in Ito CHOW trivia*ander Ito penalties ate taker wow% <br /> ICIfIS szs.gx6,4,a that f,two so:Arai-ad this docurreol,and ta Ito teat tat my loweiralse,4 li In"roma.mad corte4011e. <br /> sign,Afirairma .• . <br /> bare IF <br /> 14111•1r, 'aril'...1171° , N <br /> Ad. <br />