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ED Application for Proration of Property Taxes r+EGEW Due to Damage by Fire or Act of God Date received Oregon Revised Statutes(ORS)308.425 MAR 0 8 2021 Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,thArmstErnyeagf9Wint of tax due or result in a tax refund.The tax year is from July 1 to June 30. p�q� �nR •Your application must be filed within 60 days of the damage or by June 30 of the tax year in which the damage occurred,whPL7i`ii' s a er. •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name 1 p15. / .....,,,Iso, t i a I n ee ) Gam, Mailing addressc_gs�5th�/ // /� 1k Emai (optin�QJ 4,Q f7,�/j`/ WWw i City iV(Azivez.„ 7111s1... ZIP d5 earl Location and description of damaged or destroyed property Assessor's account number • P ‘---1Z f56571,- 618O r,. Location of property(if different from above) Section Township Range Tax lot number 175 Detroit Ave N 01 BC 10S 5E 18300 Da ptio of personal property Detroit, OR 97342 `arf,L • Date of damage ^n Cause of damage C �'��Od� ire(attach fire department report) 0 Act of God(describe): k 1. .! - _ , , d/�S had Dana ccurr o , ❑Land %Building OO Personal property 0 Manufactured structure Describe damage ,20/O /Vend w; 7 - 0 /Pile/ r's 4zadifedndiv; /z,d,„. Application for proration of tax I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted A, ithin 60 days of damage or June 30,whichever is later. 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- 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 and finalize the tax proration. Declaration 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 it is true ,.•;f• t,and co r e. i i 2/Z/A‘2%2/ Appl ' s signature 5-7Date —A/plicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: 3-t-Z 1 Cleric tic Date received: 3/ 8 ZoZI Cleric ZT Damaged property: This year Land and improvements: �—, Real market valueVibef RMV after Date rebuild complete: Months prorated: fire/act of God: 5-M1 S/ 0 fire/act of God: -71,390 Assessed value(AV)jygf_oya Value 70 Amount of adjustment/refund: -------- fire/act of God: S t1 O�n00 percent of loss: 79 Destroyed property: This year Personal property: 's t r, 41Months prorated: ! RMV before RMV after fire/act of God: fire/act of God: AV before Value Aitwbnt of adjustme /11: 2 d1 2,t•69 fire/act of God: percent of loss: Remarks: Date property visited: I 2/7/Z0Zo 0 Damaged ADestroyed 150-310-083(Rev.12-15)