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ernC <br /> Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date received <br /> Oregon Revised Statutes(ORS)308.425 1 L - 20 <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 /> Terry R. Behrens 503-476-7200 <br /> Mailing address Email(optional) <br /> 10004 Wagner Rd trbehrens1@gmail.com <br /> City State ZIP code <br /> Lyons, OR 97358 OR 97358 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> ,540858, , <br /> Location of property(if different from above) SGecti Township Range Tax lot number <br /> 9 <br /> Description of personal property <br /> Household contents,cars,equipment and tools <br /> Date of damage Cause of damage <br /> 9/8/2020 0 Fire(attach fire department report) ®Act of God(describe):Beachie Cr fire <br /> Damage occurred to <br /> l Land J Building 0 Personal property 0 Manufactured structure <br /> Describe damage <br /> House, Garage, Barn,fencing and live stock feeders are a total loss, extensive timber damaged throughout all tax lots <br /> IA\V O <br /> Application for proration of tax <br /> ❑x I am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be submitted <br /> 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,correct,and complete. <br /> X ' }14(—)0 10/9/2020 <br /> Applicant's signature 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: 2-1-21 Clerk: at Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Date rebuild complete: Months prorated: Real market value(RMV)before RMV after <br /> l�� ''��((��VVAA fire/act of God: _57/0 fire/act of God: �/a <br /> g'�gY{{L, erR/TEifuhtl: VE ONLY Assessed value(AV)before Value <br /> AT fire/act of God: ?9d percent of loss: <br /> Destroyed property:`'NO CH�NGr T0'T AAA tear Personal property: <br /> Months prorated: RMV before RMV after <br /> fire/act of God: fire/act of God: <br /> AV before Value <br /> Amount of adjustment/refund: -" fire/act of God: percent of loss: <br /> Remarks: Date property visited: 0 Damaged 0 Destroyed <br /> Aix a^SSop "or /0-26,24z0 <br /> 150-310-083(Rev.12-15) <br /> SI/4ree 't c r- *DS 59 �i� NorScr- 4p,' i g�v i ' 350 <br /> � �-iFt'tic 3ist+ <br /> 146vp o,✓`y A V tt e,Rpo,i_ Z_oyo ,r7.11057.: <br />