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2 <br /> �C�CE�M�D <br /> JUN 212022 <br /> ®`pn�e r �o 4/1 <br /> f Orange County Tax <br /> ]7 32 <br /> 4 <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: <br /> To Whom It May Concern: <br /> I,(PRINT NAME) � � `? lZ' ^✓,�� <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year �Levl� <br /> on T x bst� ar el Identificatio�Number(s) Il�# <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 exp l in' <br /> How did you find out about the program(s)? <br /> Thank you, <br /> r <br /> (Signature) <br />