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Request for Appraisal Review Office Use Only <br /> Log#: 1ZI_ 019 <br /> Taxpayer please fill out this side only Date: 11/3 h l <br /> Filing Deadline is the first Friday in December Taken by: Ute ren,.- <br /> Pleaseuseseparatereviewsheetsforeachaccount 01(# RECEIVED <br /> Date: U13)st NOV 03 2021 <br /> Have you appealed to the Board of Property Tax Appeals?: C Yes 7 No MARION COUNTY <br /> ASSESSOR <br /> Review Requested By(if different than 11p_ropertly owner):/ /� <br /> AI'ICiv Z.1.,) ki0V1•GL1e Email: �W�'EL,[( 1YnMooOf�dll �ne: 5) — 2//.3 <br /> Owner Name: / <br /> Owner Mailing Address(complete address): <br /> '112 Solna\sao . Gk sl: Si41d.Wl / () - <br /> Street Address of Property for Review: k¢42_ JV.4rrAA ck City: StAiuA <br /> Map/Taxlot k: 0I31,3334ADWb Account No.: 5 :34% <br /> Real Market Value Requested: <br /> Land: ligt$00 . OD <br /> Structures: None Total: 4$7/58x,0 O <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> Lok is vcr 1 61g:( M.I4c ke> bw:\Z an Ibecattsc of Site?'WS s 1 Stat( / f <br /> cc fc54cratarts. <br /> WW1/4\b bC filed 4o y te-1- szwtbodi kir SA-t- w\vevt r•CNie.J ZS Crr.4-1 <br /> 1;14+`VA4Aii \I ,Ja/ <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 />