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10 <br /> ®`a ge �o4h E <br /> u <br /> s <br /> ORANGE COUNTY <br /> T "MINISTRA,TION <br /> a <br /> 'Ib C8tio�`� <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 <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 Zd 2 n <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <br /> 9 09177g�OG� <br /> In accordance with North Carolina General Statute 105-282.1(al),I submit the reasons)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: ee <br /> • �c� c.Lt a � �c-� Sly�to � c.�E' 't't� CA l�0.�L� �'�"�/ <br /> How did you find out about the program(s)? ON <br /> nk you, <br /> (Signature) <br />