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IA Application for Proration of Property Taxes For county use only Date received Due to Damage by Fire or Act of God Oregon Revised Statutes(ORS)308.425 Instructions: •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 of tax due or result in a tax refund.The tax year is from July 1 to June 30. •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. •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name Phone Betty Jo Ely 209 329 2328 Mailing address Email(optional) 20460 Deerhaven Dr shaksoc@mac.com City State ZIP code Tuolumne CA 95379 Location and description of damaged or destroyed property Assessor's account number Location of property(if different from above) Section Township Range Tax lot number 110 Deer St S 02DA 10 05E 1500 Description of personal property Detroit, OR 97342 Date of damage Cause of damage 09/10/2020 E Fire(attach fire department report) ❑Act of God(describe): Damage occurred to 0 Land El Building 0 Personal property 0 Manufactured structure Describe damage 2 car garage with backroom&bath was consumed by fire & reduced as large pile of building materials. A W 4:3 Z ac Application for proration of tax > N n Ds CI I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application nal be tsmitt i W within 60 days of damage or June 30,whichever is later. U tL 0 co Whether my property is damaged or destroyed will be determined by the County Assessor's office.If the assessor determines my plarty isiaaly dat Q 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 thiduty tb aticuli and finalize the tax proration. Declaration 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 it is true,correct,and complete. X 40// IL *____. 6 2 Applican' signatu� Dat?//‘/2 —Applicant will be notified of the county's decision— For tax collector's use only For assessor's use only Date received: 2•24-ii Clerk: / r Date received: Clerk: Damaged property: This year Land and improvements: Date rebuild complete: �-Monthsprorated: Real market value((RMV�pjg re RMV after P fire/act of God: /77 4�i� fire/act of God: Z b �] Assessed value(AV)b r Value Arr tjefd7 6400 ,„-c-gr'r fire/act of God: D percent of loss: Destroyed proppijOb ►VIC►`�s I JA V is year Personal property: !, O WM— ontthhsprorated: RMV before RMV after N fire/act of God: fire/act of God: _ AV before Value Amount of adjustment/refund: fire/act of God: percent of loss: Remarks: I Date property visited:--('//r 0 Damaged El Destroyed 05.FA /1.4'3 r1 di i"cj. A cc S may /4, Pl« t* . 150-310-083(Rev.12-15)