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                                                                                          2023

Form OR-PDTA, Property Tax Deferral Application, Instructions 

Instructions                                                Property’s physical  address. List the address 
                                                            or where the property is physically located in 
• Print or type your application.
                                                            the county.
• Complete the application in full, including 
the required household income and asset                     Manufactured structure. If the property is a 
worksheet on the back.                                      manufactured structure, complete the follow-
• Sign and date your application.                           ing information on the application: model year, 
                                                            make, home ID number, and serial number.  
• Attach a copy of your       2022–23 property tax 
statement.                                                  Eligibility questions. Fully complete questions 
• Individuals with disabilities: Attach a copy              1−6. 

of your Social Security Disability award                    Household income worksheet. List your yearly 
letter received before April 15 (we won’t ac-               household income for 2022. Household income 
cept your 1099 SSA statement or new benefit                 consists of all income of the applicant(s) and 
statement).                                                 their spouse(s) that reside in the home. Include 
• File your completed application with the                  income earned in other states or countries. 
county assessor’s office      after January 1               Your household income must be less than 
and by April 17.              Late filing is allowed from   $55,500 (taxable and nontaxable income) to 
April 18 to December 1 with payment of a late               qualify for the 2023–2024 property tax year. We 
filing fee, determined by the county assessor.              may require verification of the information you 
Applicant section. Check the box to indicate                provide in this section. 

whether you are applying as: an individual,                 Taxable and non-taxable combined household 
joint applicants, surviving spouse, adding a                income must be included on the income work-
spouse, or applying as a disabled heir.                     sheet for all applicants (and their spouse) that 
Social Security number (SSN). The request for               live in the home.

your SSN is authorized by United States Code                Asset worksheet. We may require verification 
Section  405, Title 42.  You must provide  this 
                                                            of the information you provide in this section.
information. It will be used to establish your 
identity for tax purposes.                                  List the total net worth of all applicants. Net 
                                                            worth means the sum of the current market 
Current residence address.    State the current 
                                                            value of all assets includ ing real property, cash, 
mailing address you receive your mail at. If 
                                                            savings accounts, bonds, and other invest-
your current residence is different than the 
                                                            ments after deducting outstanding liabilities.
property’s physical address, indicate the rea-
son. If you’re living away from the property                Don’t include the value of your home, the 
for medical reasons, you must include a letter              cash value of life insurance policies on the life 
from your doctor written on letterhead stating              of an applicant, or tangible personal property 
that you are required to be away from home for              owned by an applicant (for example, furniture 
medical reasons.                                            or vehicles).

150-490-014-1 (Rev. 07-25-22)                             1                          Form OR-PTDA Instructions



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Declaration section.          Be sure you read this   attach a copy of your Social Security Dis-
  section before you sign.                            ability award letter. Proof includes: your 
                                                      Social Security Disability award letter, or 
Signature. All applicants must sign and date 
                                                      a computer printout of your benefits veri-
the application. If you are needing someone to 
                                                      fication letter from SSA. Don’t send your 
sign or make decision on your behalf, you can 
                                                      1099 SSA statement or new benefit state-
find a Power of Attorney form on our website. 
                                                      ment as proof. If you need help getting 
Attach the following to your application:             your award letter, go to the SSA website at: 
                                                        www.ssa.gov/signin or by calling SSA toll-
• A copy of your 2022-23 property tax 
                                                      free at 800-772-1213.
  statement.

• If you’re applying as a disabled applicant 

            Your application must be filed with the county assessor’s office  

                              after January 1 and by April 17,  
                              or from April 18 - December 1 with a late filing fee. 
  Send the original application to the county assessor’s office (see county addresses).  
  We will notify you in writing by September whether your application is  approved or denied. 
          If approved, we will pay your future taxes beginning November 15, 2023.

150-490-014-1 (Rev. 07-25-22)                       2                               Form OR-PTDA Instructions



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                               County Addresses 

Baker County Assessor                     Douglas County Assessor 
1995 Third Street, Suite 130              County Courthouse 
Baker City OR 97814                       1036 SE Douglas Avenue, Room 206 
Phone: 541-523-8203                       Roseburg OR 97470 
                                          Phone: 541-440-4222
Benton County Assessor 
                                          Gilliam County Assessor 
Department of Assessment 
                                          County Courthouse 
4077 SW Research Way 
                                          221 S Oregon Street 
PO BOX 964 
                                          PO Box 484 
Corvallis OR 97339 
                                          Condon OR 97823 
Phone: 541-766-6855
                                          Phone: 541-351-9173
Clackamas County Assessor/Tax Collector   Grant County Assessor/Tax Collector 
Development Services Building             County Courthouse 
150 Beavercreek Road                      201 S. Humbolt Street 
Oregon City, OR 97045                     PO Box 10 
Phone: 503-655-8671                       Canyon City OR 97820 
                                          Phone: 541-575-0107
Clatsop County Assessment & Taxation 
820 Exchange Street, Suite 200            Harney County Assessor/Tax Collector 
Astoria OR 97103                          County Courthouse 
Phone: 503-325-8522                       450 N Buena Vista Avenue, #13 
                                          Burns OR 97720 
Columbia County Assessor                  Phone: 541-573-8365
230 Strand Street                         Hood River County Assessor        
St. Helens OR 97051                       601 State Street 
Phone: 503-397-2240                       Hood River OR 97031 
                                          Phone: 541-386-4522
Coos County Assessor 
250 N Baxter St.                          Jackson County Taxation Office 
Coquille OR 97423                         10 S Oakdale, Room 111 
Phone: 541-396-7900                       Medford OR 97501 
                                          Phone: 541-774-6059
Crook County Assessor 
                                          Jefferson County Assessor 
200 NE 2nd Street, Suite 200 
                                          66 SE “D” Street, Suite D 
Prineville OR 97754 
                                          Madras OR 97741 
Phone: 541-447-4133
                                          Phone: 541-475-2443
Curry County Assessor                     Josephine County Assessor 
94235 Moore Street, Suite 221             County Courthouse 
Gold Beach OR 97444                       500 NW 6th Street, Dept. 3 
Phone: 541-247-3294                       Grants Pass OR 97526 
                                          Phone: 541-474-5260
Deschutes County Assessor 
                                          Klamath County Assessor 
1300 NW Wall Street, Suite 204 
                                          305 Main Street, Suite 106 
Bend OR 97701 
                                          Klamath Falls OR 97601 
Phone: 541-388-6508
                                          Phone: 541-883-5111 

150-490-014-1 (Rev. 07-25-22)           3                            Form OR-PTDA Instructions



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                                 County Addresses (continued) 

Lake County Assessor/Tax Collector             Sherman County Assessor 
Lake County Courthouse                         County Courthouse 
513 Center Street                              500 Court Street 
Lakeview OR 97630                              PO Box 283 
Phone: 541-947-6000                            Moro OR 97039 
Lane County Assessor                           Phone: 541-565-3505
Dept. of Assessment & Taxation                 Tillamook County Assessor 
125 East 8th Avenue                            201 Laurel Avenue 
Eugene OR 97401                                Tillamook OR 97141 
Phone: 541-682-4321                            Phone: 503-842-3400
Lincoln County Assessor                        Umatilla County Assessor 
Lincoln County Courthouse                      County Courthouse 
225 W Olive Street, Room 207                   216 SE 4th Street 
Newport OR 97365                               Pendleton OR 97801 
Phone: 541-265-4102                            Phone: 541-276-7111
Linn County Assessor                           Union County Assessor/Tax Collector 
300 4th Ave SW, Room 214                       1001 4th Street, Suites A & B 
PO Box 100                                     La Grande OR 97850 
Albany OR 97321 
                                               Phone: 541-963-1002
Phone: 541-967-3808
                                               Wallowa County Assessor 
Malheur County Assessor 
                                               101 S River Street, Room 104 
County Courthouse 
                                               Enterprise OR 97828 
251 “B” Street W, Suite #2 
                                               Phone: 541-426-4543 Ext. 1146
Vale OR 97918 
Phone: 541-473-5105                            Wasco County Assessor 
                                               Department of Assessment and Tax 
Marion County Assessor 
                                               511 Washington Street, Room 208 
555 Court St NE, Suite 2233 
                                               The Dalles OR 97058 
PO Box 14500 
                                               Phone: 541-506-2510
Salem OR 97309 
Phone: 503-588-5144                            Washington County Assessor 
Morrow County Assessor                         Department of Assessment & Taxation 
100 Court Street                               155 N First Avenue, Suite 130 
PO Box 247                                     Hillsboro OR 97124 
Heppner OR 97836                               Phone: 503-846-8741
Phone: 541-676-5607                            Wheeler County Assessor 
Multnomah County Assessor                      701 Adams Street, Suite 203 
Division of Assessment, Recording & Taxation   PO Box 447 
501 SE Hawthorne Blvd, Suite 175               Fossil OR 97830 
Portland OR 97214                              Phone: 541-763-4266
Phone: 503-988-3326                            Yamhill County Assessor 
Polk County Assessor                           County Courthouse 
850 Main Street                                535 NE 5th, Room 42 
Dallas OR 97338                                McMinnville OR 97128 
Phone: 503-623-8391                            Phone: 503-434-7521

150-490-014-1 (Rev. 07-25-22)                4                               Form OR-PTDA Instructions






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