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Request for Appraisal Review Office Use Only <br /> Logs: --/-, 2/_ 0)/ <br /> Taxpayer please fill out this side only <br /> Date: 'f/3/zi <br /> Filing Deadline is the first Friday in December <br /> Taken by:______ b rt.. <br /> Please use separate review sheets for each account <br /> (12,49 <br /> Date: 1\61/, .� ):20,4162- SCAN ED <br /> Have you appealed to the Board of Property Tax Appeals?: r Yes ilt N�niIo <br /> Review Requested(� By(if different than property ownerr)): ' I U <br /> Owner Name: l 'tC elm. F Cha n Q-y Email: Qe—I `h `o) /10'1 X Ia� I,cmone:5�3�rr/ONf <br /> I c'.5o 33 3- -1 <br /> Owner Mailing Address(complete address): <br /> c20 a0 IST"ry Ce1+ r±Saifi Salem I, Of< ?730a <br /> Street Address of Property for <br /> ttReview• ,g.10 1/11.4. 11X6 043N e, City: ,S•/�,�(ln <br /> W <br /> Map/Taxlots: 13 3 D t( R Account No.: 5R / t <br /> / C / <br /> 0 3DDD [ <br /> Real Market Value Requested: 1 <br /> Land: IOD, POO Structures: .) a5) bQ0 Total: 3, 5} boo <br /> Please provide/�,�additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> AU.a,CAed ant, IS brut._ � - my c a mora ur 4 Vwl 0 <br /> a Arott crt AQ e. . . . , -r..�.. 11 - 9 .1.4 a <br /> tio-abz. <br /> o fr_ - <br /> t:t4 <br /> . k 1O ° 1134-t114"¢ �''auSo 61/44 � ZAPt <br /> � ^, r a,» ix y1 <br /> to 41.D.,--.61MIA-1.AM cry <br /> 1 <br /> mwi ntA!!!y11I � Cso ite3 <br /> m : s a ��a�peri e „ 2icQ fVPlea ema o pleted formsto: assessor@cus L9rXJ� a� � •�fl'v" P <br /> You may also print and mail copies of completed forms to•� Atm; o3�333-�� a <br /> Marion County Assessor (+-Yu- ok:o`) <br /> `L ry 4 <br /> P.O.Box 14500 � �'E <br /> Salem,OR 973090tuto rvtl 46i) <br /> Co‘j °""`6 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 />