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Nov. 2. 2020 10: 50AM Mar ion County No. 0384 P. 3 Application for Proration of Property Taxes For county use only Due to Damage by Fire or Act of God °`se received 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.If approved,this may reduce the amount of tax due or result In a tax refund.The tax year ie 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 S-ietie et. G l 503-5S1-2'16I Mediu address Email(opilonal) D. 133ix 96s car K>r �+, StaleVd ZIP code y� h 7 !1 k 17392.- Location and description of damaged or destroyed property Assessor's account number R41248 ! 541248 vocation of property Of different from above) Section *Township Range Tax lot number 25375 Santiam Park Rd SE 0926a-co- pj(tot, Description of personal property Lyons,OR 97358 tif9 ,I'GI"9S Dr r ivec�ruiv} Fr6 — Dale of damage Cause of damage w * io-a ? )(Fire(attach fire department report) 0 Act of God(describe): t. mitred ocuared to .and K3uildIng 0 Personal property 0 Manufactured structure v Describe damage n? qti 4e `°� oocCQ • Application for proration of tax Q��' .lam applying to have the above property examined for proration of property taxes per ORS 308.425.Application must be su ittZ1 within 60 days of damage or June 30,whichever is later. Whether my property Is damaged or destroyed will be determined bythe County Assessor's office.If the assessor determines my property Is only dam- aged,I must notify the tax collector of the dale that the damage la 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 swearing[ORS 305.990(4))that I have examined this document and to the best of my knowledge it is true,correct nd c mpl e. • X Applicants b to l Jt 12,/ Z' �' Apps a —Applicant will be notified of the county's decision— For tax collector's use only For aeceasor'a uee only Date received: 2.-14-24 Clerk: /i _Dale received: pert-. Damaged property: This year Land and Improvements: Date rebuild complete: r` Months prorated: Real market value RMV)before RMV after U p „ flre/act of God: i7 /0 D fire/act of God: Ji/�A C `PE Assessed value(AV)be Value ret t�[ lire/act of God: percent of loss: Destroyed ppgr . C.O�m This year Personal property N Cl f►ti _ RMV before RMV after 140 rU+s- Months prorated: fire/act of God: fire/act of God: AV before Value Amount of adjustmenVrefund: '"' fire/act of God: percent of loss: Remakus Q ��y Date property visited: 0 Damaged IV eetroyed so 414---otirearlit-t_ i2ps-izao 150-510-095(Rev.12-15)