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11 <br /> ®iaV'Qe , CIO,, OCT 14 2022 <br /> f Orange (,ountV Tax <br /> 17 52 <br /> �o y <br /> rah C,AVG <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: I0� <br /> To Whom It May Concern: <br /> 19(PRINT ) °I T NAM y <br /> wish to be considered for Property Tax Exemption,Exclusion or Deferral for the tax year 1-C) , <br /> on Tax b tr ct or Parcel I/dentificati Number(s)(PIN)# <br /> 7(Q, r <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 /> AAqti . <br /> S:�EQ046 144 alIC6�-I'q /2 <br /> l <br /> t <br /> C <br /> r / <br /> How did you find out about the program(s)? l � r <br /> Thank you, <br /> (Signature) <br />