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Request for Appraisal Review Office Use Only <br /> Taxpayer please fill out this side only Log#' 7-21 -01 <br /> Filing Deadline is the first Friday in December Date: D Z I <br /> /l //rr <br /> Pleaseuseuse separate review sheets for each account Taken by: ((/�� AL <br /> ' <br /> Date: IO JZf?l2( !,'_s/yes>-- <br /> Have you appealed to the Board of Property Tax Appeals?: ('Yes ,No r tin <br /> Review RequestedBy(if different than property owner): <br /> Ss.1uIdLD <br /> Owner Name: mkt --7/ 3, .y �S�q-I LLA <br /> b/y J /� dQ�L Email T A4/0 Phone: J`0,3� l <br /> — <br /> OwnerMailingAddress(c m letea ess): y Ail.t .2g1 7 <br /> ��� 5 /��,e._ //6��-yy S r,-„,",- <br /> /,q lar 9730 - <br /> Street Address of Property for Review: 2/ Y6 c A /� f/' R0( .. Lim <br /> �s.5 <br /> VYJJ ff// ' a City: [/.1/N(/� <br /> Map/Taxlot#: mfZj/ D0030C:7Account No.: / 'ZO 22) <br /> Real Market Value Requested: <br /> Land: Structures: .r <br /> Total: <br /> Please provide additional information and documentation supporting your requestevalue.Attach additional documents if necessary. <br /> f root+l'eoti;cq/f' <br /> -/ girt tee 6t /t z7. zo ,o‘t✓i <br /> on ,/2.z_ . <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 />