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Application for Proration of Property Taxes For county use only <br /> Due to Damage by Fire or Act of God Date receives <br /> Oregon Revised Statutes(ORS)308.425 <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'I 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 <br /> � a1L�X-ra_ j !/c—/---R(`— <br /> P�3 5 ---9—,i.7‘ f <br /> Mailing addressEmail(optional) e <br /> 5 /7 g As I / 5 17 <br /> — <br /> S_ il ck E!` <br /> Ct <br /> City l ‘,..-\. eN1Cq$'�i /t <br /> State ZIP code <br /> Dk 77317 <br /> Location and description of damaged or destroyed property <br /> Assessor's account number <br /> I( ` D / 36.-7 iScfD ( 3(c7 <br /> Location of property(if different from above) Section Township Range Tax lot number <br /> 3s/& S+ Sc tion cif _ <br /> jpiv'Piet/property <br /> � LH"—� <br /> Dat of damage Cau of damage ON J`)•/1/'� �!�I YfA <br /> Vi" ZC� Fire(attach fire department report) El Act of God(describe): rS S t ,ft <br /> Damage�/ occurred to �� 't--so.... <br /> �,I Land Building ,F�Rersonal property 0 Manufactured structure / <br /> Describe damage (, bi.(rn.,, cJC c�t'^�. ��`,),0 2�-1- Ca = <br /> L.u <br /> N <br /> eo 0 cNl) <br /> w z <br /> Application for proration of taxell <br /> W W oa <br /> XI am applying to have the above property examined for proration of property taxes per ORS 308.425.Application must beesssubmitted <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 /> X4�7,---kS 7. /3;12,A-CA, 9-- / - <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: Clerk: Date received: Clerk: <br /> Damaged property: This year Land and improvements: <br /> Real market value(RMV)before RMV after <br /> Date rebuild complete: Months prorated: fire/act of God: fire/act of God: <br /> ' Assessed value(AV)before Value <br /> Amount of adjustment/refund: fire/act of God: percent of loss: <br /> Destroyed property: This year 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: <br /> percent of loss: <br /> Remarks: Date property visited: ❑Damaged ❑Destroyed <br /> 150-310-083(Rev.12-15) — <br />