LINN COUNTY ASSESSMENT AND TAXATION

[Pages:1]LINN COUNTY

ASSESSMENT AND TAXATION

P.O. Box 100; Albany, Oregon 97321 Phone: (541) 967-3808 FAX: (541) 917-7448 Web: co.linn.or.us

Andy Stevens

Assessor & Tax Collector

REQUEST FOR DISQUALIFICATION FROM SPECIAL ASSESSMENT (Exclusive Farm Use)

TO: LINN COUNTY ASSESSOR

Date _______________

Regarding

ALL; -OR PART (see attached description or map of the part to be disqualified);

Of the specially assessed land included in the following tax lot:

Account No. _______________, Map _______________________ Tax Lot ________

This parcel is in an Exclusive Farm Use Zone, and has been receiving special assessment,

and is no longer being used as farm or range land; -OR-

I/we hereby request you disqualify the above described lot or parcel for valuation at real

market value as required by planning decision.

I/we acknowledge that the Assessor will impose the additional tax or penalty, if any.

The undersigned are the owners of the above described lot or parcel.

_______________________________________________ _________________________

Signature

Telephone

_______________________________________________ _________________________

Signature

Telephone

ASSESSOR'S ACTION:

To be completed by Assessor's Office

The Linn County Assessor hereby certifies that:

The property described has been disqualified; and valued at real market value; by

removing the special assessment for farm/ranch use;

The owner of the lot or parcel has been provided written notice of the disqualification;

and

The additional tax or penalty, if any, has been imposed.

___________________________________________

Representing Linn County Assessor

_______________________

Date

Form EFU_disq_req

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