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9 <br /> © fti <br /> 17 52 <br /> 4 <br /> or�� QLar°i�� <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 ah d Q.' <br /> t <br /> To Whom It May Concern: <br /> Ii(PRINT NAME) p��� <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year �b I <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <br /> C� gJ Li -S <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 explain: <br /> T h ox C� + pcAy it l OVv� l <br /> How did you find out about the program(s)? 1 -e_V-1 A' <br /> Thank you, <br /> (Signature) <br />