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17 <br /> eta UAle, <br /> FILED <br /> T7 �� SEP 2 5 20M <br /> $pr�4 �nx"� ORANGE COX i, <br /> TAX ADMTNNT4l w'Ss,1'•+ <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: `�' �j ` aX0 <br /> To Whom It May Concern: <br /> 1,(PRINT NAA7N) <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 /> U to S 1 O <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: 'S 1• t aft tg►� - -.i-`-�•-c o`er- - c`�w' .�''c�- <br /> c�P.ss,.r-�.��Iw 1a., hl L©�c � �"��zA.� �.� • .��,eL c.�-i.v SS vsc�..�L.-1't�.- _ <br /> 6 <br /> tip.... -t�c�y. •,r�r� ��, .�..�,-� c�-, c , rr, A--�. <br /> How did you find out about the program(s)? Qr""' `A-1�i C-VN <br /> Thant:you, <br /> (Signature) <br />