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Attach $281 Fee <br /> Instructions Follow <br /> IN THE OREGON TAX COURT <br /> MAGISTRATE DIVISION <br /> Property Tax <br /> Sabra Health Care Holdings III LLC , ) <br /> FILED <br /> Name(s) ) <br /> Plaintiff(s), ) MAR 19 2021 <br /> versus ) <br /> Marion COUNTY ASSESSOR, ) MAGISTRATE DIVISION <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-too W S G (for court use only) <br /> State of Oregon, ) <br /> Defendant(s). ) COMPLAINT <br /> SECTION 1. Tax year(s) appealed: 2020/21 . Plaintiff(s) (circle one)owne leased property <br /> identified by the assessor as account number(s) 575210 (If multiple accounts listed, <br /> the identified property must be contiguous or adjoining); <br /> the property is(circle one): Residential Omitted '-ommerciJ 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 Copy of the Order,Letter, Notice, or Other Document Being Appealed* <br /> SECTION 3. Such order, letter, or notice is in error because the Real Market Value for the above-captioned <br /> account is in excess of the Market Value. <br /> SECTION 4. Plaintiff(s)request(s)the following relief or real market value: The Real Market Value be <br /> reduced from$6,528,670 to$3,570,873. _ <br /> Sabra Health Care Holdings III LLC Gregory A. Damico, Tax Advisors, PLLC <br /> Plaintiff's Name(PRINT)(must be completed) Representative's Name(PRINT)* <br /> CPA#8473 <br /> Additional Plaintiff's Name(PRINT) Representative's Oregon Bar or License Number <br /> 10220 SW Greenburg Rd., Unit 201 203 SE Park Plaza Drive, Suite 230 <br /> Mailing Address(must be completed) Mailing Address <br /> Portland, OR 97223 Vancouver,WA 98684 <br /> City, State,Zip(must be completed) City,State,Zip <br /> (503)595-2810 (360 50-6884 <br /> Telephone Number(must be completed) T' 'hon. umber <br /> at Notify me of proceedings electronically. I 10, <br /> understand that if I am ever a party to a case in ' >. esentative's Signature(if above completed) <br /> another Oregon court,I may receive electronic notices <br /> from that court as well.My email address is: 3 (7 2( <br /> Date Signed <br /> appeals@taxadvisorscpa.com <br /> PLEASE SEE ATTACHED AUTHORIZATION * If your representative is not an Oregon lawyer, an <br /> Plaintiff's Signature Date Signed Authorization to Represent must be completed and <br /> submitted with this Complaint. An authorization form is <br /> Additional Plaintiff's Signature Date Signed available by request or at our website at <br /> http://courts.oregon.gov/courts/tax. <br /> Rev. 10/19 <br />