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19 <br /> uoLED <br /> JUL 2 5 2017 <br /> 3 1 1'1 ORANGE COUNTY <br /> f "46rt'.1 ADMINISTRATION <br /> s2 TAX ADMINIST <br /> r4 eatO��r <br /> Request for Approval of <br /> Property Tax Exemption, Exclusion or Deferral <br /> Due to Showing of Good Cause for Failure to Make a Timely Application <br /> Date: '7 ia5i 11 <br /> To Whom It May Concern: <br /> I,(PRINT NAME) t. U S Sr 4 ► J <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year Q Q <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <br /> In accordance with North Carolina General Statute 105-282.1(al),I submit the reason(s)set forth below for <br /> consideration As demonstration of good cause for failure to make a timely application. An untimely <br /> application approved under G.S. 105-282.1 (al)applies only to the property taxes levied by the county or <br /> municipality in the calendar year in which the untimely application is filed. If additional space for <br /> explanation is needed,please submit an attachment with this request. <br /> Please explain: <br /> * y� / <br /> .L)11_,D/YL. ,u <br /> a <br /> How did you find out about the program(s)? <br /> Thank you, <br /> ner Q�t <br /> (Signature) 40 <br />