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5 <br /> f� FILED <br /> u DEC 2 0 2018 <br /> � ®RANGE CO <br /> O"jh Cato rAX ADMn STRAnON <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: <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 /> z 2 <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 /> • * -c�Z/ �' � Gam. GllLt- �J� n <br /> • Gil +5��''� �L �- tu'�-�� <br /> How did you find out about the program(s)? j/l <br /> Thank you, <br /> (Signature) lJ <br />