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F • \ Application for Proration of Property Taxes For ��a only Due to Damage by Fire or Act of God Dat°`°`°'"°d Oregon Revised Statutes(ORS)308.425 i D-( 2- c 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 CEN w 1S =T. E tNG ,,J& C.tv[06- 1Bt.JSa 5D3. St 5. 1 SOp Mailing address 1 i (f . Q '� A JY� Email(optional) City JamtlWiIIK Y15.e � h PSC+ c i� State 'ZIP co e Location and description of damaged or destroyed property Assessor's accoouu�nttt number Location o property(if different from above) (.� .A, ' � Section Township Range Tax lot number �Ul 3) 9 Willi ILI mer Description of personal property _4. _ Z.t O °113414 ALS `ZWLZ I"nBe15 Date of damage Cause of damage 61-7-. 0 ❑Fire(attach fire department report) 1Act of God(describe):Wtd..MEE Dam ge occurred o Land t j3uilding >j Personal property ❑Manufactured structure Describe damage AU, Putl.D1Akr& EAR.We'D 62 AM PLET aY. AU- LAN OSIC,A Pt 5ulaidai GDM p bi/ . 4 iie 13u2Ne 4 t4etb 'Tb 55 Rx-mUvin) cue ID 51,F6TV• Application for proration of tax I am applying to have the abovero e p p rty 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 declare and 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,Corr t,ancq ompl . X JfrApplicant's sig ure 0 Lr• Z 'LO Za Date —Applicant will be notified of the county's decision— For tax col ector's use only For assessor's use only Date received: Clerk: Date received: /0.-2Z-2020 Clerk: C L. D Damaged property: This year Land and improvements: /f3 o6O — Real market value(RM before RMV after Date rebuild complete: Months prorated: fire/act of God: fire/act of God: /Jo/N�/ Amount of adjustment/refund: Assessed value(AV)before jai deg Value fire/act of God: '7 L'' percent of loss: • 24%2_ Destroyed property This year Personal property: Months prorated: � RMV before RMV after fire/act of God: 5555. fire/act of God: VasArnd: AV before Value Amount of adjustmen 3 Z.0 79 fire/act of God: - percent of loss: Remarks: Date property visited:— El Damaged Destroyed A/f ityl 6'r",' .d. 150-310-083{Rev.12-15) 7 i i t