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• `1 o`T C C_c6 Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God Date received Oregon Revised Statutes(ORS)308.425 (D--- 5 -2O 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 Susan Crowder 503-559-9791 Mailing address Email(optional) PO Box 405 sjcrowder54@gmail.com City State ZIP code Detroit OR 97342 Location and description of damaged or destroyed property Assessor's account number M132392 I 2-...3.9 2 Location of property(if different from above) Section Township Range Tax lot number 215 Patton St S 01 10 5E CB09300 Description of personal property Everything is gone Date of damage Cause of damage Wildfire 9/7/2020 ❑Fire(attach fire department report) 0 Act of God(describe): Damage occurred to E Land E Building E Personal property 0 Manufactured structure Describe damage Burned to the ground Application for proration of tax 0 I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted within 60 days of damage or June 30,whichever is later. 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- 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 and finalize the tax proration. Declaration I -clare nder the penalties for false swearing [ORS 305.990(4)]that I have examined this document and to the best of my knowledge it r rue, 'orre , d complete. X -` ___i 9/25/2020 Applicant's s• ture Date —Applicant will be notified of the county's decision— • For tax collector's use only For assessor's use only Date received: 12-1-7..0 Clerk: /?j Date received: Clerk: Damaged property: This year Land and improvements: Real market value ef9rg RMV after Date rebuild complete: Months prorated: ----s _ fire/act of God: a`0 fire/act of God: Assessed value(A efore Value y D O Amount of adjustment/refund: fire/act of God: percent of loss: Destroyed property: This year Personal prope Cr RMV before RMV after Months prorated: _ fire/act of God: fire/act of God: AV before Value Amount of adjustmen efund: 3 28.O0 fire/act of God: • percent of loss: Remarks: Date property visited: ' I . 12"• 2d 0 Damaged Mestroyed /4-t- 61, .-' ' V C.,•-•t. 'it' •c_c./ 10 ‘e ‘,)Sr--Al p it r A 5 150-310-083(Rev.12-15) -- - _________ —