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11 <br />r <br />DEC 0 7 2017 <br />17 52 <br />ORANGE COUNTY <br />TAX ADMMISTRATION <br />a <br />h CaY °��� <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: 1-! <br />To Whom It May Concern: <br />I, (PRINT NAME) <br />wish to be considered for Property Tax Exemption, Exclusion or Deferral for the tax year <br />on Tax Abstract or Parcel Identification Number(s) (PIN) # <br />q818-14 310l Q9 LL-L <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 (a1) 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 e: <br />How did you find out about the program(s)? <br />Thank you, <br />(Signature) <br />