Form 150-303-076 - Request For Hardship Review
Download a blank fillable Form 150-303-076 - Request For Hardship Review in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 150-303-076 - Request For Hardship Review with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Clear Form
Request for Hardship Review
For Conference Unit use only
Under Oregon Revised Statute (ORS) 307.475
You may apply to the Department of Revenue by December 15 of the tax year if your exemption, special assessment, proration of tax,
or request for valuation as of July 1 has been denied by the assessor due to lack of a timely application.
Petitioner’s name
Telephone number
Telephone number to call for conference
(
)
(
)
Address
City
State
ZIP code
E-mail address
Use e-mail for correspondence?
Yes
No
Property address, if different from above
City
State
ZIP code
County where property is located
Assessor’s account number(s)
Tax year(s)
Exemption or special assessment program
Farm use special assessment
Oregon active military exemption (attach your orders and other
Forestland special assessment
documents showing the period of your active service)
Small tract forestland option
Disabled veteran or surviving spouse exemption
Proration of tax or July 1 determination of value
Religious, fraternal, or charitable exemption
due to damaged or destroyed property
Other exemption or special assessment
Reason for the late filing
The department may recommend the assessor accept your application for exemption, special assessment, proration of tax, or valu-
ation as of July 1 if you had good and sufficient cause for filling the application late. Good and sufficient cause is an extraordinary
circumstance beyond your control, as further defined in Oregon Administrative Rule (OAR) 150-307.475 (see next page). Please
explain why you were not able to file your application timely:
Declaration
I declare under the penalties of false swearing [ORS 305.990(4)] that I have examined this document and to the best of my knowl-
edge, it is true, correct, and complete.
Signature of petitioner or authorized representative
Print name
Date
X
Authorization to represent
If you choose to be represented, you can only be represented by a person listed below. All correspondence will be mailed to that person.
I authorize
to represent me before the Department of Revenue.
Signature of petitioner
Print name
Date
X
Authorized representative address
My authorized representative is (check one):
A person licensed or authorized to perform real estate
City
State
ZIP Code
appraisals in Oregon.
A real estate broker as licensed under ORS 696.022.
E-mail address
An attorney licensed to practice in Oregon.
Telephone number
A public accountant or enrolled agent licensed to prac-
tice in Oregon.
(
)
My employee regularly employed in tax matters.
Mail to: Property Tax Division, Oregon Department of Revenue
PO Box 14380 Salem, OR 97309-5075
150-303-076 (Rev. 04-12)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial