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Request for Appraisal Review Office Use Only <br /> Log N: 1-21'01 <br /> Taxpayer please fill out this side only <br /> Date: I Q/RS/J-c-2� <br /> Filing Deadline is the first Friday in December <br /> Taken by: .DS . */ 3 <br /> Please use separate review sheets for each account <br /> C�q,,', <br /> rib 1 <br /> Date: I 0/X54-I � t <br /> Have you appealed to the Board of Property Tax Appeals?: ,1 ('Yes •No SC " 1ED <br /> Review Requested By(if different than property owner): Andy Collins y C,,,,ftQiler ,f7 /i✓ctcl.. Hill G4pi4-41 <br /> Owner Name: Orerion Seka ioval Email: a.viy“,wvlicH6;licapil c.aim Phone: 31o.-24%-845 <br /> Owner Mailing Address(complete address): <br /> 1333 2^a Si- , Ste &5o Santa Mc..:.a , CA 90401 <br /> Street Address of Property for Review: 2.450 Sirotij Rd sc _ City: Sgle,+, <br /> Map/Taxlotu: 083602.8001#s4 AccountNo.: 532.143 <br /> Real Market Value Requested: <br /> Land: Structures: Total: fP 2� C,0 eh d7c 2 <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <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.ohus/CO/Pages/bopta.aspx <br />