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8 <br /> I LEP <br /> r� <br /> DEC 3 0 2021 <br /> a_o <br /> ORANGE COUNTY <br /> TAX ADMINISTIZA'ITION <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: I a I 4Q I off-C 4 <br /> To Whom It May Concern: <br /> I,(PRINT NAME) •.l/(i-V; A [A k Q t I� Ll , <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year (��� <br /> on Tax Abstract or Parcel <br /> /Identific}ation Number(s)(PINE >)# ��� I©qD <br /> 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 (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 r co pc n a fq v a <br /> s <br /> How did you find out about the program(s)? L Q <br /> Thank you, <br /> (Signature) <br />