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, 17Y\ea-:—(2 Application for Proration of Property Taxes L ._ For cnuniy t_e only Due to Damage by Fire or Act of God ei `' Oregon Revised Statutes(ORS)308.425 Instructions: •Application for proration of property taxes may be made for the tax year of the propert-, d.,rraoerde_a.= tan.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 h the damage occurred.whichever is later. •File your application with the county tax collector of tate county in which year ca.t iag_d prof;e` t is located. App'c is came . /P) gc--/-7—f 1 su g3267rc Mailing addressI r-- - l'optionaif777fminerc,w Sr- i , ge 1hcacni, Citc..-__ a `a ZIP od a .. '' 97Z0 y 1 01 Location and description of damaged or destroyed property Assessor's account number - R41234 / 541234 Location of property(f different from above) 1Section 1 irovrisnip I Rafige 1 rax lot r umb^r 25522 DeWitt Ln SE 122D i 09S 12E 600 De.icription c'per ac ni property ,^ � Lyons, OR 97358 j � `��. 2 G ( rl / V'tE'.._-.C-OL ( ? D r o drag 1 Ca se of carriage � 7 w2.0 j Fera(attach fire aopartr lent report) Act t of God(describe): i t. Dam ge occ rred ro l Land Building , Personal property Li MariLifactured structure 1.:2 -ii4b ami_ °N. _ _ -- -- ---......---- ick e s S c)--- 140 vyl e nt_k i s 1 1 t r) I W/ I ye,y�O (l � 1be.10 v7 I v1�5 (� Application for proration of tax I am applying to have the above property examined for proration of property faxes 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 Assessors 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 inionr,the tax collector of their duty to calculate and finalize the tax proration. Declaration I declare u ',ter the p nal`' s or fal-I,sweatin '•• ' 305.990(4)}that I have examined this document and to the best of my knowledge it is true, . --ct,a c., . . 1X X ,. ,� i it/c Z-t) ? 0 Applica r nature -a_. __- —Applicant will be notified of the county's decision— For•ax collector's use only For assessor's use only 4 Date received: 111,3,1d Clerk:/?l _ -.Da r i cure-:: QaJ-_ 0"....---- r r'' P)lZ vlCl _._... -__1 Damaged property: This year Land and improv ments: — .�� „ ./+ Red! n :.et value "vV ,"O-a fR 4 af.ot 565,6 Date rebuild complete: Months prorated: fire ..f of God: j , f;re r 1 of Gca Assessed value(AV)b ,if:: 221 u (� Amount of a sfi ere ret-nd firerac .C,Gt± �e • l //Y� �51�bc� o -,-- Destroyed property: This year Personal property: Rt,11r before Rti,illt of e' Months prorated: 43 fire/art of God: °„r a_ of God: I r �5�1 U7V A4 before ague Amount of ad(uatmentrigl, 5 fire a t of God: percent of loss Remarks: ) '7, , , Date visite 'l� Damaged estrov2d ifirtdi _ lrX/ l1' 7� .�-- ,etr,1+0os.5ta.v 12-15r