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2,144(/042p'.61711/ .1=1111 <br /> Application for Proration of Property TaxesFor sou use. <br /> Due to Damage by Are or Act of God Date`°�" I <br /> Oregon Revised Statutes(ORS)308.425 <br /> Instructions: <br /> VII' • V. N1Y <br /> •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this maMslitaMeErgi:Mii <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 /> Applicant's re Cr&Q G7rvs,e/)/a_.Al Gre&' 5D 3 764 35-5--Mailing <br /> Mailing 7 &) _ lv ere f a 'mgr S <br /> City ZIP code //� <br /> G1/c1 q7 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> 5/i4/6Location of property(if cifferent from_ �_ 1Lft 44s 13E1�S4/49-DOv Sv <br /> Section Township� �� Range ax lot number <br /> 0 Li 7 4M71/4 All*- � 6�_ <br /> of P C Pmp .ty(l <br /> evertS 6R tiod56, BO/ch//7b1 1 r6 5 <br /> Date o damage Cause of damage <br /> q7 -8 I i), O Mire(attach fire department repots ❑Act of God(describe): <br /> •< _._[occurred <br /> Dettartd�lding / property 0 Manufactured structure <br /> 40. <br /> epLI ( i /E- . / tiet'►z Gvllo/4A-C l :.ep f i? ) Uel v. <br /> td eon 7 U1-ts huA/L€''( in )Oz)/td( ' out3UI id6041,-. J <br /> 12AdALeAktiaa-144411-- 01-11d GO7f—tpz 4 t1rr'u -1`--e <br /> Application for proration of tax <br /> iffOrn 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 RS 305 •=• , 1 •_. I have examined this document and to the best of my knowledge <br /> itisirup <br /> :-7z,'f° <br /> X ye/ie.( ( 1Z { \w ( l "496eZ!) <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 Cleric Date received: Cleric <br /> Damaged property: This year Land and improvements: <br /> DReal market value(RMV)before RMV after <br /> Date rebuild complete: Months prorated <br /> firelact 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: 0 Damaged 0 Destroyed <br />