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Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God °efeieceived <br /> Oregon Revised Statutes(ORS)308.425 <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 /> 72oh65,z t4 lu rl-94 ra... C-u✓,et - 5.e. 86171- 2471 <br /> Mailing address <br /> n .0. <br /> 1` 0 �Emai(optional) <br /> �/ r0 bh( 4rer6gin . etrvic. <br /> City <br /> _! StateZIP code 3 v 4 <br /> Jv( Location and description of damaged or destroyed property —<A <br /> Assessor's account number <br /> 541414 / R41414 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 10043 North Fork Ln SE 11AB 09S 3E 100 <br /> Description of personal property <br /> Lyons, OR 97358 <br /> Date of,hagCa of damage <br /> //e/01.41 ,, ire(attach fire department report) 0 Act of God(describe): <br /> Dammagepecurred 114to <br /> I�Cand L�13uilding PIersonal property ❑Manufactured structure <br /> Describe dg t <br /> G�� �'ro wd <br /> nFillj <br /> gN <br /> cq o2 <br /> z � <br /> C CD <br /> n <br /> Application for proration of tax :. <br /> am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> 11 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,corr t,and complete. <br /> X ` �-r q// 7/2 O <br /> Ap <br /> %sjre <br /> Date <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: /0 43. 20 Clerk:4 466 a)v <br /> Damaged property: This year Land and improvements: <br /> Date rebuild complete: `. Months prorated: �, Real market value M before RMV after �.�//}} <br /> fire/act of God: fire/act of God; ;7 SO <br /> Assessedvalue(AV)befsore 5O percent of loss: 0.213(o <br /> Value <br /> Amount of adjustment/refund: fire/actt ofof God: {� <br /> Destroyed propB1ty: This year Personal property: <br /> RMV before RMV after <br /> Months prorated: q <br /> fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/rrdmd: — 38 3,73 fire/act of God: percent of loss: <br /> Rema y v/ /�� Date property visited: /0•/5-20 ❑Damaged strayed <br />