Applicant and Property Information - PDF document

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n n n n n n n n Applicant and Property Information Signature of Property Owner Date Last Name First Name M.I. Social Security Number Mailing Address - Street own State Zip Code Telephone (Work) Property ID or Parcel Number (found on your property tax statement)Address of Damaged Property (if different than mailing address)Legal Description of Property (found on your property tax statement) Is the property homesteaded? w many months was the property unable to be occupied or used? es No e you left property: ____________________________________________ Date you returned to property: _____________________________________ designated as a disaster or emergency area? Yes No Application for Local Option Disaster Abatements and Credits By signing below, I certify, to the best of my knowledge, the above statements are true and correct. (Rev. 11/13)If your property has been damaged or destroyed by a natural disaster or other type of accident, you may be eligible to receive some property tax relief on this year’s and next year’s property taxes. The type of tax relief you receive will depend on whether your property is homesteaded, whether it is located within a declared disaster or emergency area, the amount of damage sustained, and a number of other factors. If an assessor has not already reassessed your property, you should contact your county assessor’s of�ce and request that an assessor view the damage for the purpose of receiving disaster relief. Sign Here CR-LODA Statement of Facts _______________County Applicant’s statement of facts. (Please list type of disaster, type of damage, and any other information you deem relevant.) For Of�ce Use Only Approved Denied ________________________________ Assessment year ____________ Assessor’s signature ________________________

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______ Date _______________________ Use of Information For Of�ce Use Only Land vements otal Class Tax Capacity ax Before Other Credits ax Payable Credits Post-damageReduction Market Value Signature Date Final Certi�cation I hereby report that I have investigated the statements made in this application and �nd the facts to be as follows:Report of investigationI certify that at a meeting held on ________________ , ___________ , the County Board, took the above of�cial action on this abatement. This action was duly adopted and entered upon the minutes of its proceedings as a public record, showing the name(s) of taxpayer(s), other concerned persons and the amounts involved. InvestigatorThe following accurately re�ects both existing and proposed amounts. Signature Date Amounts ax is Paid ax is Not Paid Date ax Rate Approval Certi�cationsCerti�cations of approval. For this abatement to be approved, the assessor, county auditor and the county board of commissioners must all favorably recommend its adoption. oved Denied Signature Date County auditor’s recommendation oved Denied Signature Date County board of commissioner’s action (to be completed by the county auditor) oved Denied Signature Date Certi�cations of �nal approval (complete only for approved abatements). This section to be completed by the county auditor.I further certify that the approval of this abatement has resulted in the following changes: eduction of Tax $ ________________________ eduction of Penalty $ ________________________ eduction of Interest $ ________________________ otal Reduction/Refund $ ________________________ Total Payable $ ________________________ n n n n n n n n n n n