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x <br /> I Application for Proration of Property Taxes For county.use onl` = - <br /> Due to Damage by Fire or Act of God Date received <br /> Oregon Revised Statutes(ORS)308.425 ".cAR _ <br /> Instructions: <br /> • <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. -f- <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. 's; <br /> •File your application with the county tax collector of the county in which your damaged property is located. - <br /> Ica t' <br /> APPI re - <br /> Y+C.:I� Il j/ ( Phone <br /> Mailing address Email(optlonaQ <br /> gD 3 ./�/LC, �a f)l A v r� e bin *1- tom -.V <br /> City 04- I I State LP eod7��e C. <br /> Location and description of damaged or destroyed property �/) <br /> Assessor's account number <br /> 540901 / R40901 <br /> � <br /> Location of property(if different from above) Section Township Range Tax lot number - <br /> 25779 Taylor Park Rd SE 10DC 09S 2E 1000 i <br /> Description of personal property <br /> Lyons,OR 97358 (to7)+ES�7-obe-S ,6upptd,c 1 <br /> Date ofa Cause of damage SA'ij?/Ayn 111-o.�/f' <br /> 9 /ol(j�0 0 Fire(attach fire department report) %Act of God(describe): <br /> Da a occurred to <br /> land Building p4ersonal property 0 Manufactured structure <br /> Describe damage <br /> CU/ . 1r2g.- OA) 9//0 11104 9/9/0 sriwy e,tnp Y -l-i- <br /> t c wl c1 C fl,1 p- P -~'._ <br /> S Pki)6) �l 000 5-4090 <br /> Application for proration of tax <br /> I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> in 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 swearing[ORS 3 .990(4))that I have examined this document and to the best of my knowledge <br /> it is true,'co ,and compleette/f �� e <br /> 942F,te 1 <br /> Applicant's gna urs ` ,. <br /> Date <br /> I. <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: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Date rebuild complete: Months prorated: Real market value(RMV)before RMV after - <br /> fire/act of God: fire/act of God: <br /> ' Assessed value.(AV)before Value I, <br /> r- Amount;of adjustrnent/refund: fire/act of God:. percent of loss <br /> pestroyrd property This year. Personal property <br /> - RMV before' RMV after - <br /> Months prorated fire/act of God . fire(act of God <br /> ' AY before Value f <br /> Amount of adjustmerdhefund• _ fire/act of God patient of loss. <br /> Date property visited: ❑Daimaged 0 Des r yed <br /> I <br /> r <br /> I. <br /> to cF< - t s -f <br /> r # } <br /> -a ', <br />