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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 36. <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 /> Applicant's name Phone <br /> • <br /> 4c r r l'et- L Vee. s 03 -- g , 3 -- ; kf 4 <br /> Mailing address f_ Email(optional) <br /> 1 S6S3 S (A) Shr'0 Utiet3 <br /> City State ZIP code <br /> nik. � l�VI Vi (Le— 0 C.(—1 E7 ie., f 7 /Z 9 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> R / / -14 / , 7L R '�Location of property(if different fromove) Section Township Range Tax lot number <br /> 01 73 ° fwcc,..7f Circ SE <br /> Description of personal property <br /> LnS OR `t73S8cIe2r d� h 1^s ! sked <br /> Date of damage Cause of damage r, <br /> q - - a_o O ❑Fire(attach fire department report) Act of God(describe): e S+ 'Ii r <br /> Damage occurred to <br /> Mend ®.Building P ersonal property El Manufactured structure <br /> Describe damage t - Q �� I _ t <br /> rve <br /> 1,f e �+04(O r ) - i s �u e>� <br /> tW o z <br /> N QC <br /> Application for proration of tax W ao ) u <br /> am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must Esube tted O v <br /> within 60 days of damage or June 30,whichever is later. CW Q e <br /> Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my propel 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 true,correct,and complete. .� 7 <br /> X � - i5 - o is <br /> Applicant's 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: Clerk: Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Real market value(RMV)before RMV after <br /> Date rebuild complete: Months prorated: fire/act of God: fire/act of God: <br /> Assessed value(AV)before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Destroyed property: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Remarks: Date property visited: ❑Damaged ❑Destroyed <br />