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• Request for Appraisal Review Office Use Only <br /> Lag d: - 053A <br /> Taxpayer please fill out this side only 2/Z / <br /> Date: <br /> Filing Deadline is the first Friday in December <br /> Taken by: !1 her <br /> r <br /> Please use separate review sheets for each account <br /> ref ,ry / <br /> Date: 1�/�/� <br /> Have you appealed to the Board of Property Tax Appeals?: C Yes (�No `w QI" <br /> Review Requested By(if different thanfproperty owner): /i, LLII � <br /> Owner Name: �(s`�ll( (� l_!7 ( 7Pei Email: smok.(yl ylQ ea+lgla_ Phone: 343 Owner <br /> evta Lc 4/ <br /> Owner Mailing Address(complete address): <br /> AP s kr✓e §1 . //n, f /0 0 <br /> Street Address of Property for Review: ///B')0�y City: �f /ve�,Mn <br /> Map/faxlotk: 4) 1\13 SA0.`VO [O t 1 Account No.: 0 77 3 <br /> Real MarketValue`'u��e Requested: <br /> quested: <br /> Land: Structures: 3� 1 13 7 Total: 304, ‘ , 3q95 <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> 1111` Oc*tr rQpf des /5 Va /0e of U11i+( C0v773) 401 <br /> gqiaQ.Q 630 `710 vwrcln ��urchase fr le ' � 3c41 [34j/ <br /> Sg1{e 4q-/e 17/2//2-0< <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.orus/CO/Pages/bopta.aspx <br />