Clear Form
REQUEST FOR TRAINING CREDIT
Department of Revenue Use Only
PROPERTY TAX DIVISION
Date Received
INSTRUCTIONS
• Mail, fax, or e-mail this form along with copies of your certificate(s) of completion to the Department of Revenue to
request credit for training.
• The Department of Revenue will notify you by e-mail of approval or disapproval of your request for training credits.
Requestor
E-mail
Employer
Date of Request
Type of Training
Technical/Appraiser Certification
Management
Course Location
Course Date(s)
Length of Time (hours)
Sponsor/Accreditation
Course Title
Briefly describe the course: (or attach a copy of the course outline)
Explain how the course applies to continuing education requirements:
Training credit is requested for: (attach additional sheet if necessary)
Name
Position
Was course completed?
No
Yes Date course was completed: ___________________________________
DEPARTMENT OF REVENUE USE ONLY
Approved
MAIL TO:
Management
Technical/Appraisal
Credit hours earned: _________
Appraisal Training
Property Tax Division
Oregon Department of Revenue
Course # _______________________
PO Box 14380
Salem OR 97309-5075
Not Approved
OR
Reason: _______________________________________________________________________________
_______________________________________________________________________________________
E-MAIL TO:
continuing.education@state.or.us
Authorized by: ____________________________________________ Date: __________________________
150-338-002 (Rev. 07-11)