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Office Use Only <br /> Request for Appraisal Review Log#: j - � <br /> 0 54 <br /> Taxpayer please fill out this side only Date: 14 V lfl <br /> Filing Deadline is the first Friday in December Taken by:c1j11 (�l1 <br /> Please use separate review sheets for each account <br /> 61D <br /> Date: D3 Dec_ 2..,o <br /> Property Tax Appeals?:eals?: ('Yes •No tiee111/� <br /> Have you appealed to the Board of �� <br /> Review Requested By(if different than property owner): <br /> "� rr r ail: Phone:(.SO.5) PY/'8518 <br /> Owner Name: j /es7 C. i' `7 I.6R/ lJ o/v//o�c LL CO/fo/l. ,%C,./l! C <br /> Jor,4 • Co ',v. <br /> Owner Mailing Address(complete address): <br /> /676 A1e07,‘ Jr .✓c SA i.,,,., DR 7 730 i <br /> Felvari✓stoQ mi¢K. Apz Ke(a i .:7 ) City: A�l Lm✓ <br /> Street Address of Property for Review: rea.,1/4J�,�/ooa /4'fi2K il'�'2 / C$.6 L: c, /O ) <br /> Mapffaxlot#: () -A3 It10t3/300/00 Account No.: 1210; 3 <br /> 0j T.M' it 0130° S <br /> Real Market Value Requested: 60 <br /> n <br /> Land: ye /OO, 00DO Structures: 10. 00Total:flJP1OOO v <br /> Please provide additional information and documentation supporting your requested value.Attach additional documents if necessary. <br /> RECEIVED <br /> DEC 0 8 2'J21 <br /> MARION COUNTY <br /> ASSESSOR <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 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 />