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Iimmommusim i : C Application for Proration of Property TaxesDate received For county use onl Due to Damage by Fire or Act of God y Oregon Revised Statutes(ORS)308.425 Instructions: •Application for proration of property taxes may be made for the tax year of the property damage/destruction. of tax due or result in a tax refund.The tax year is from July 1 to June 30. If approved,this may reduce the amount •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 lat er. •File your application with the county tax collector of the county in which your damaged property is located. Applicant's name ' � Phone N. L. Mailing address 5 03- 7( �] 2575 75 I �h 0 ?G Q Email(optional) l 54 FQ'j'lr J Ci 1 t�- State ZIP code ib O► . `173: Location and description of damaged or destroyed property Assessor's account number R98088 /598088 Location of property(if different from above) 100 Detroit Ave N Section Township O 1 BC Range Tax lot number 10S 5E 16900 Detroit, OR 97342 Description of personal property Date of damage Cause of damage ` - e�b 0 Fire(attach fire department report) 4ct of G • Damage occurred to (describe): LW t c F( g— jCt _ oddescribe i 0 Land 0 Building 0 Personal property 0 Manufactured structure Describe damage il Application 00 . 2020 A PP on fkrior proration of tax am applying to have the above property examined for proration of property taxes per ORS 308.425.Application lication mu at` Gack within 60 days of damage or June 30,whichever is later. �� s d 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 under the penalties for false earing[ORS 305.990(4)]that I have examined this document and to the best of my knowledge it is true,correct,and complete. / X13 I Applicant's signature 1 b DateyC J —Applicant will be notified of the county's decision— For tax collector's use only Date received: -`o-20 For assessor's use only Damaged property: Clerk: � Date received: I�mZz oo Clerk: ZT - °— This year Land and improvements: Date rebuild complete: Months prorated: Real market value lyl b fire/act of God: L 40 RMV after rio fire/act of God: •"? �. Amount of adjustment/refund: — Assessed value(AV)b-fore Value Q 4 Destroyed property: fire/act of God: D� percent of loss: O , ! 0 / This year Personal property: �Y Months prorated: RMV before RMV after fire/act of God: fire/act of God: Amount of adjustmen refund '7 AV before Value I /'t2.7S fire/act of God: Remarks: percent of loss: Date property visited: I 12010 0 Damaged Destroyed 150-310-083(Rev.12-15)