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APPLICATION FOR ABATEMENUADDITION OF - SPECIAL ASSESSMENTS <br />Applicant/ <br />Applicant/ Owner Telephone N <br />Date of Application 02-19-10 <br />DESCRIPTION OF PROPERTY <br />For Taxes Assessed in 2009 <br />and Payable in 2010 <br />Please print or type. <br />Applicant/ Owner Mailing Address <br />City of Centerville, 1880 Main Street <br />7389 Mill Road <br />Property I.D. or Parcel Number R14-31-22-31-0016 <br />Street Address (if different than above)I City or Township School District Number <br />Centerville 1 12 <br />LEGAL DESCRIPTION OF PROPERTY <br />APPLICANT'S STATEMENT OF FACTS <br />Ms. Jaques made payment to the City of Centerville on March 30, 2009 to satisfy said assessment. <br />APPLICANT'S REQUEST <br />Include fund number & amount due for payable tax year being abated, not total principal amount. <br />Fund #84264 — Scheduled Payment - $2,079.39, Principal Payment - $982.65, Interest Payment - $1,096.73, Principal Remaining - $18,957.92 <br />Applicant's Signature <br />Date <br />NOTE: Minnesota Statutes 1988, Section 609.41, "Whoever, in making any statement, oral or written, which is required or authorized by law to be made as <br />a basis of imposing, reducing or abating any tax or assessment, intentionally makes any statement as to any material matter which the matter of the <br />statement knows is false my be sentenced, unless otherwise provided by law, to imprisonment for not more than one year or to payment of a fine of <br />not more than $3,000, or both." <br />The following accurately reflects both existing and proposed amounts. <br />