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Request for Appraisal Review Office Use Only <br /> LogTaxpayer please fill out this side only �' ^ 0(]3 <br /> Date: /0/;,, 2 / <br /> Filing Deadline is the first Friday in December <br /> Taken by:#9L�_ ��,�p <br /> /P/l'ease use separate// review sheets for each account -� <br /> Date: f °/ ��/7i/ <br /> c ` It <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes X No VYr Third <br /> Review Requested By(if different than property owner): <br /> Owner Name: 41/en j tta+ Email: Phone: 3d3—SSE' 6707 <br /> Owner Mailing Address(complete address): 7:t <br /> 53 ,E <br /> Street Address of Property for Review: City: <br /> Map/Taxlot N: Account No.: 13 I ' 7 <br /> Real Market Value Requested: <br /> Land: Structures: $./O/ 0 CO Total: 470/a0n <br /> Please provide additional information and documentation/ supporting your requested value.Attach additional documents if necessary. <br /> ygne1"JuiJ Sfruc7vrt 14 ref- do i 7 of/ — tiistukfilS/ <br /> c �I lr S/ &/ , I <br /> r 9.„,„,„›GvUw °" No+ itakt <br /> 514 �Pn(r•of,_"tit` <br /> Fb � <br /> Y� ^ M " r�1,i18� <br /> 5� ld- fru <br /> e <br /> ir ✓d <br /> a +a <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.orus/CO/Pagesibopta.aspx <br />