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5 <br /> [_ <br /> rT <br /> Ere# Orange CountyTax <br /> f <br /> 17 52 <br /> $ t <br /> `tee <br /> ��h �Atial <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 /> �t <br /> I,(PRINT NAME) ��� rcLs 10 ej ' � <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year "-)-o ste <br /> on Tax Abstract or Parcel Identification Number(s)(PIN)# <br /> RS3S11Cl 0f7A, <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: <br /> CVOc.oOC s O / - o�-�-oO <br /> How did you find out about the program(s)? <br /> Thank you, <br /> (Sig ture) <br />