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uqo-L0 5 <br /> FILED <br /> �pr�e . co 4 <br /> AUG 21201? <br /> ® rp <br /> El E: ORANGE COUNTY <br /> E:r- 0-` g TAX ADMINISTRATION <br /> W-.117 52 <br /> Q <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: (141 17 <br /> To Whom It May Concern: <br /> I,(PRINT NAME) -- i an n e 14 .tea v)S , <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year 20 If/ <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <br /> In accordance with North Carolina General Statute 105-282.1(a1),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: 1 <br /> - I(LA' 4“:11.11 t I 'was e `i t . <br /> How did you find out about the program(s)? r i-PJY1�� <br /> Thank you, <br /> (Signature) <br />