Landowner Information Form - Tar River Land Conservancy

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Landowner Information
Form
Thank you very much for contacting Tar River Land Conservancy about options to protect your
property for conservation. To help to prepare for a discussion of your conservation options, please
provide the information below. Please mail this form to Tar River Land Conservancy, P.O. Box 1161,
Louisburg, NC
27549 or fax to us at 919-496-6940. Our land protection team will review this
information and be in touch to discuss the conservation options that might be available to you!
DATE:
FORM COMPLETED BY (check one): Staff: ________
Landowner(s): ________
CONTACT INFORMATION:
Name:
________________________________________________________________
Address:
________________________________________________________________
________________________________________________________________
Phone (h):
________________________________________________________________
Phone (w):
________________________________________________________________
Phone (m):
________________________________________________________________
Email:
________________________________________________________________
Best time & method to contact you: ______________________________________________
How you learned out about Tar River Land Conservancy: ____________________________
___________________________________________________________________________
PROPERTY LOCATION INFORMATION:
Acreage:
________________________________________________________________
Township:
________________________________________________________________
County:
________________________________________________________________
Address or road name(s): ______________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Tax Parcel ID number(s): ______________________________________________________
Names of river/stream/creek on the property: ______________________________________
___________________________________________________________________________
___________________________________________________________________________

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