Farmland Assessment

Ownership:

Phone:

Email:

Parcel Number(s):

Total Acres:

Acres

Irrigated Crop Land:

Acres

Irrigated Pasture Land:

Acres

Dry Crop Land-Tillable:

Acres

Dry Graze Land:

Acres

Orchard:

Acres

Type of Livestock:

Number of Animals:

Length of time grazed annually:

Dates of use (Ex. May-July):

Dry Graze or Irrigated Pasture is fully fenced:

Yes No

Is gate locked?

Yes No

Type of crop grown:

Quantity per acre:

Is irrigation water available for all crops:

Has land been actively devoted to agricultural use for at least two successive years immediately preceding the tax year in which application is requested:

Yes No

Is property being leased?

Yes No

If yes, Lessee name:

Electronic Signature by checking, Owner affirms and declares the above information is true and correct.

Electronically Signed

Farmland Assessment Act Questionnaire