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iff <br /> Application for Proration of'PropertyTaxes For county use only <br /> ' Due to Damage by Fire or Act of God date received <br /> Oregon Revised Statutes(ORS)308.425 <br /> Instructions: <br /> a <br /> :APof <br /> plic tion'fo proration of property taxes may be made for the tax year of the property damage/destruction.if approved,this may reduce the amount <br /> 'taX due or resuit 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 /> Applikanttf • <br /> V <br /> `/ t�I Phone._,3 f >p3 39t�2 <br /> Email{o tionaQ k4aRklg aderh5c>12 \I-A-cic, e,) )1itt. R,o ,s'.c friA-giA-y0A-vii-u&miotz, G/1')fl'�L ci tri <br /> city • S Ok �P�'7.3.00 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> 540902 t `R40902 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 25597 Taylor Park Rd SE 10DC 095 2E 1100 <br /> Description of personal property - <br /> Lyons.OR 97358or <br /> ♦ / <br /> a Cause of damage <br /> Date <br /> f 77740010 0 Fire(attach fire department report) 'Act of God(describe): . ale rill <br /> Dami.ge occurred to <br /> r.gland property ©Manufactured structure <br /> Describe damage <br /> 1 .gc �Z,tlLirc,co 912/471,0 9/9 � ) y <br /> V g4u- mou ca-ctR ,�„o ,4. ).2 P& oa /OP D�, , <br /> Application for •roration of tax <br /> oam applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> ithin`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,corse and complete. <br /> x /7 - G/ y /1rfaa <br /> Applicant's signature Date <br /> Applicant will be noted of the county's decision- <br /> For tax collector's use only For assessor's use only ;: <br /> Date received: cleric Date received: Clerk <br /> Damaged property This year Land and Improvertiantx <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 adjustmenthefund: fire/act God: percent of loss: <br /> # <br /> Destroyed proprrty: <br /> This year <br /> Personal property: <br /> RMV before RMV after <br /> Months prorated: fire/act of God fire/act of God: <br /> AV before Value t <br /> • Amount of adiustment/refimd fire/act of God: percent of loss " ` v , . ri <br /> Date propertyvlsited. 0 Damaged® <br /> fteina►ks' ® ' � � � } <br /> 1Sa.3td.1e3 92-151 <br />