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Request for Appraisal Review Office Use Only <br /> Log#: I of ^ 003 <br /> Taxpayer please fill out this side only <br /> Date: / b// 2- <br /> Filing Filing Deadline is the first Friday in December #9y <br /> Taken by: <br /> Please use separate review sheets for each account <br /> Date: °/27/71 <br /> 1> r' <br /> Have you appealed to the Board of Property Tax Appeals?: C'Yes ^No �` 'y lois <br /> Review Requested By(if different than property owner): <br /> Owner Name: / 744 �j u45+ Email: Phone: ,�03—$5.6' 6707 <br /> Owner Mailing Address(complete address): A <br /> Street Address of Property for Review: '-/ City: <br /> Map/laxlot#: Account No.: 13 I 1 / Z <br /> Real MarketyValue Requested: <br /> Land: Structures: $'pi/ 0 co Total: 70100-D <br /> Please tprovide(radditiorrnal information andnddocumentation supporting your requested value.Attachttadditional documentsntif necessary. <br /> �AnirR,04Ure; 1(t) ere— ! 4 p05r L iff/'TI'of1 — G✓%AGCet/il <br /> %4� Ufa s, e/c / <br /> I <br /> Please email completed forms to: assessor@co.marion.or.us <br /> You may also print and mail copies of completed forms to: <br /> Marion County Assessor <br /> P.O.Box 14500 <br /> Salem,OR 97309 <br /> THIS IS NOT AN APPEAL <br /> Please refer to appeal rights included with your tax statement. <br /> To file an appeal please visit: <br /> http://www.co.marion.or.us/CO/Pages/bopta.aspx <br />