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Attach$281 Fee <br /> Instructions.Follow - <br /> 1N THEOREGON TAX COURT . <br /> MAGISTRATE DIVISION <br /> tiI Property Tax <br /> 1? ; Cy S a t + , ) FILED <br /> N t r c hn t6 r C-non o tit ate, <br /> TL2Name(s) ) FEB ".&1021 <br /> F. Plaintiff(s), ) <br /> MAGISTRATE DIVISION <br /> ,3 ne a,v COUNTY ASSESSOR, ) <br /> AND/OR ) <br /> NOTE: See instructions regarding "HEADING." ) <br /> After reviewing instructions, if you want to name the ) <br /> Department of Revenue as a defendant, check below: ) <br /> ) <br /> DEPARTMENT OF REVENUE, ) Case No. 2 l 0 0 t t(2 (for court use only) <br /> State of Oregon, ) <br /> Defendant(s). ) COMPLAINT <br /> SECTION 1. Tax year(s).appealed: c 4,2 o - 2.4., iaintiff(s)(circle of owne leased property <br /> identified by the assessor as account number(s) 1(0 i$ it 730(173 (If m ple accounts listed, <br /> the identified property must be contiguous or adjoining); <br /> the property is(circle one): Residential Omitted Commercial Industrial Forest Farm Exempt Personal <br /> Other: • <br /> SECTION 2. Plaintiff(s)appeal(s)from an order, letter,notice,or other governmental action. <br /> *Attach a Covv of the Order,Letter;Notice, or.Other Document Beink Appealed.* <br /> SECTION 3. Such order,letter,or notice is in error because .-A•i w4A-''f w n i N v_i/. N.''.T.' . . ` <br /> pS'GQaiet To ©AS VI , 2'(. 4J 711 .z23 { • <br /> SECTION 4. Plaintiff(s)request(s)the.following relief or real market value:. S7. E-- A. ;lf,�,::5� • <br /> Plaintiff's Name(PRINT)(must be completed) Representative's Name(PRINT)* <br /> V v3ooII `i' . . _ <br /> Additional Plaintiffs Name(PRINT) Representative's.Oregon B, or Licgnse Number <br /> a yf9 Si' �'ctslai:N V', Uc / ' Zz7 1 U9( sT &AA; t U,IIJL <br /> M`i ing Addr s(must be co leted) " M�}11 ng Address <br /> At;LCS l'bAo . ®2. 7/t.i' /� 1l/a u3� OR ,9' o3L <br /> i Ci Sthi <br /> City,State,Zip(must be completed) City; J,. p ,, 3 . „ <br /> S.03 -yy9-77� <br /> Telephone Number(must be completed) Tele.;tip ber <br /> : 2 <br /> 0 Notify me of proceedings electronically. I AP <br /> 1 <br /> Th., <br /> -,entative's Signature(if above completed) <br /> understand that if I am ever a party to a case in 'hep gnu . P <br /> another Oregon court,I may receive electronic notices a_Li, L/ <br /> from that court as welt.My email address is: o� <br /> Date Signed <br /> * if your representative is not an Oregon lawyer, an <br /> Authorization to Represent must be completed and <br /> Plaintiff's Signature Date Signed <br /> submitted with this Complaint. An authorization form is <br /> available by request or at our website at <br /> Additional Plaintiff's Signature Date Signed http://courts.oregon.gov/courts/tax. <br /> Rev. 10/19 <br />