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cr bW <br /> Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date received <br /> Oregon Revised Statutes(ORS)308.425 q—(5 - 7Q <br /> Instructions: <br /> •Application for proration of property taxes may be made for the tax year of the property damage/destruction.If approved,this may reduce the amount <br /> of tax due or result in a tax refund.The tax year is from July 1 to June 30. <br /> •Your application must be filed within 60 days of the damage or by June 30 of the tax year in which the damage occurred,whichever is later. <br /> •File your application with the county tax collector of the county in which your damaged property is located. <br /> Applicant's name Phone <br /> - vvnP, . GoC)s(1_lv�s Ff3- 45?- tot S <br /> M5ilkng addresi_Th Email(optional) <br /> PD -c (p07__ <br /> City Stalk f ZIP -1358 <br /> J Location and description of damaged or destroyed property <br /> Ass s`Ic0 ynumber CA / 54 Oc ( <br /> Location of property(if different from abov Section Township Range Tax lot number <br /> 2(p k c1 7 ►n�-{10` \Ir1K �i d 5 cr....,_ t t c09 2 l� ca cic)v <br /> J Description of personal property <br /> Date of damage Cause of damage <br /> C Fire(attach fire department report) JZ Act of God (describe): (ail la <br /> \ (�-`- 8 -bre/Dam a occurrJd to / <br /> Land 9'Building piPersonal property ❑Manufactured structure <br /> Described mage <br /> ui 1►1c --k f ei en Summ e� every -1-h n <br /> • <br /> / Application for proration of tax <br /> .ja am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> within 60 days of damage or June 30,whichever is later. <br /> Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my property is only dam- <br /> aged,I must notify the tax collector of the date that the damage is repaired.Such notice will serve to inform the tax collector of their duty to calculate <br /> and finalize the tax proration. <br /> Declaration <br /> I declare under the penalties for false swearing [ORS 305.990(4)]that I have examined this document and to the best of my knowledge <br /> it is true,correct,and/ complete.xa.e7uLe. ///1 <br /> PPIi signature9tr-Thzsdv_6,4_, Date 15 .2020 <br /> —Applicant will be notified of the county's decision— <br /> For tax collector's use only For assessor's use only <br /> Date received: Clerk: Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Real market value(RMV)before RMV after <br /> Date rebuild complete: Months prorated: fire/act of God: fire/act of God: <br /> Assessed value(AV)before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Destroyed property: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Remarks: Date property visited: ❑Damaged ❑Destroyed <br /> 150-310-083(Rev.12-15) <br />