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Request for Appraisal Review ;Only <br /> � <br /> Log# <br /> Taxpayer please fill out this side only Date <br /> Filing Deadline is the first Friday in December Taken by: a b Z_ <br /> Pleaseuse separate review sheets for each account <br /> Date: Oct 25,2021 <br /> Svril:% <br /> I q l(' <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes CZ No <br /> Review Requested By(if different than property owner): <br /> Owner Name:Velda Looney Email: Phone: 503-393-0180 <br /> Owner Mailing Address(complete address): <br /> 5123 Dory Ct N <br /> Street Address of Property for Review: City: Keizer <br /> Map/faxlot#:073W04A000100 Account No.: 129059 <br /> Real Market Value Requested: <br /> Land: Structures: 104,000 Total: 104,000 <br /> -- - -Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> An other adjustment of 150%was added to the improvement level in error at conversion. The MAV is correct. <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/Pages/boPta.asiax <br />