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2. LANDOWNER INFORMATION
4. Primary Owner*

   List current/new owner name

5. Owner Phone Number*
6. Email*
8. Tax Bill Mailing Address 1*
9. Tax Bill Mailing Address 2
11. City*
12. State*
13. Zip*
17. Primary Residence*

    Address of owner's primary residence

19. City*
20. State*
21. Zip*
25. AGRICULTURAL PARCEL INFORMATION
27. I am submitting a request for a soil group worksheet for the following reason(s):

    1. Initial application for an Agricultural Assessment (RP-305)
    2. Property ownership has changed (transfer / add or removed owner / life use filed)
    3. Parcel acreage has changed (as shown in a recent survey or deed)
    4. Land use has changed in any way
    5. County Real Property or the Town Assessor does not have a current soil group worksheet on file for this parcel
    6. Other reason (explain below in comments section)

    Select all that apply. Note, if you are NOT the owner of the parcel, check with your assessor prior to submission. Once this application has been reviewed by your Assessor, it will be forwarded to County Soil & Water for processing.

    NOTE: All new exemption applications and renewals are due prior to taxable status date, March 1 each year.

29. Tax Map Number*
30. Town Name*
    -- Select One --CatharineCayutaDixHectorMontourOrangeReadingTyrone
32. Parcel Location*

    (refer to tax bill or tax map)

33. Total Parcel Acres*
35. Has the parcel recently transferred?*

    1. Yes
    2. No
36. If yes, list the date the deed was filed with County Clerk.
    If yes, list the date the deed was filed with County Clerk.
38. Has a recent survey of the land been filed?*

    1. Yes
    2. No
39. If yes, list date of new/recent survey.
    If yes, list date of new/recent survey.
41. Does landowner farm the land?*

    1. Yes
    2. No
42. If yes, how many acres farmed?
44. Is any portion leased for Ag purposes?*

    1. Yes
    2. No
45. If yes, how many acres leased for Ag?
47. Leasing parties

    If leased, list name of party renting the land

48. Lease Start Date
    Lease Start Date
49. Lease End Date
    Lease End Date
51. Are there any residential homes on parcel?*

    1. Yes
    2. No
52. If yes, list number of homes
54. If there are residential structures on the property, are the occupants

    1. Property Owner(s)
    2. Farm Worker(s)
    3. Other Tenants
56. Additional Comments

    Enter any additional information here.

58. Owner Certification

    1. I certify that I am the owner of the above referenced property and have the authority to request a soil group worksheet.
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

* indicates a required field