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Request for Appraisal Review Office Use Only <br /> •Taxpayer please fill out this side only Logy' 2.1- { L <br /> Filing Deadline is the first Friday in December Date: p/2 /1l <br /> Please use separate review sheets for each account Taken by: OTGnn,,II <br /> Date: <br /> /v"_ 2 6 '� .�. I (w9 r R <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes �?'No SCANNED <br /> Review Requested By(if different than property owner): Sam <br /> Owner Name: J osc A H /t/1 / 0 (,/;a Z Email: Phone: <br /> Owner Mailing Address(complete address): <br /> 8'R£' DOde, A ye AIC ca lem o7 97-10/ <br /> Street Address of Property for Review: 15-7 ATA)6apr LA/ SF City: __S'a /ern <br /> Mapfraxlot#:0/2t13I AC(NG'(/ULAccount No.: Q6 v/oZF,566/3 <br /> Real Market Value Requested: <br /> Land: Structures: Total: <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> Please email completed forms to: assessor@co.marlon.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/Pag es/bopta.aspx <br />