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5 <br /> ' C�CGC��® <br /> SEP 2'9 2021 <br /> ®tA�%e �o4fi <br /> Orange County Tax <br /> 17 52 <br /> ��or7 h <br /> Cato <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: LQ aVI <br /> To Whom It May Concern: <br /> I,(PRINT NAME) K 1` lq- <br /> wish to be considered for roperty Tax Exemption,Exclusion or Deferral for the tax year <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <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 /> Cb Ojq <br /> ao ou Wum U <br /> How did you find out about the program(s)? V/-I <br /> l y <br /> (Signature) <br />