Application For Reassessment Of Property Damaged By Misfortune Or Calamity - Mendocino County Assessor
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1
2SUSAN M. RANOCHAK
Mendocino County Assessor
501 Low Gap Rd., Room 1020
Ukiah, CA
95482
(707) 234-6800
APPLICATION FOR REASSESSMENT
of Property Damaged by Misfortune or Calamity
1. APPLICANT _____________________________________________________________________________________
2. Mailing address __________________________________________________________________________________
3. Assessor’s Parcel Number (or Bill Number) ____________________________________________________________
Opinion of property
Opinion of property
Estimate of cost to cure
4.
value immediately
value immediately
damage to property
prior to the misfortune
following the misfortune
or acquire a replacement
TOTAL PROP. __________________________
_________________________
_____________________________
LAND
__________________________
_________________________
_____________________________
BLDG./STRUCT. ________________________
_________________________ ______________________________
PERS. PROPERTY _______________________
_________________________ ______________________________
INVENTORIES __________________________
_________________________ _____________________________
5. Date of Calamity ________________________________ Date Repaired _____________________________________
6. Description of the nature of the misfortune and the cause of the property damage: ______________________________
___________________________________________________________________________________________________
7. Description of the condition of the property immediately following its damage or destruction: _____________________
___________________________________________________________________________________________________
8. SUPPLEMENTAL DATA:
Location of Property _____________________________
Original Acquisition _______________________________
______________________________________________
Later Additions____________________________________
Use of Property _________________________________
_________________________________________________
Asking Price (if for sale) _________________________
_________________________________________________
Monthly Rent __________________________________
Total Acquisition Cost ______________________________
9. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all
information hereon, is true, correct and complete to the best of my knowledge and belief.
Executed at _______________________________________, California, this ______________________________day of
_____________________________________, 20_________ Telephone ______________________________________
___________________________________________
Signature of Applicant or Agent
NOTE IMPORTANT FILING DEADLINE INFORMATION
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