Clean And Green Application Form - Adamss County, Pennsylvania Department Of Agriculture
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1
2ADAMS COUNTY
Pennsylvania Department of Agriculture
CLEAN AND GREEN VALUATION APPLICATION
January, 2000
ASSESSMENT OFFICE USE ONLY
District
Map and Parcel Number
Assessor’s Approval and Effective Tax Year
Previously enrolled in Clean and Green
APPLICATION – PENNSYLVANIA FARMLAND AND FOREST LAND ASSESSMENT ACT
“CLEAN AND GREEN”
TO BE FILED BY JUNE 1
DATE: __________________________________
DATE OF SUBMISSION: ______________________________________
1.
Name(s):_________________________________________________________________________________________
2.
Mailing
Address:__________________________________________________________________________________________
(Street, R.D. or Box#)
_________________________________________________________________________________________________
(City)
(State)
(Zip Code)
______________________________________
(Phone)
3.
The land for which application is being made is owned by (a) (an) (Check one):
A. Individual
_____
D. Institution
_____
B. Cooperative
_____
E. Partnership
_____
C. Corporation
_____
F. Other (explain)
_____
4.
Is the land currently assessed under Act 515?
(P.L. – (1965) 1292)
Yes_____ No X .
(There are no properties in Adams County enrolled in Act 515)
5.
Is the land in this application leased for minerals?
Yes_____ No______
6.
The property is located in: ___ ________________________________________________________________________
(Township, Borough)
(School District)
_________________________________________________________________________________________________
(Map and Parcel Number)
(Deed Reference)
(Acreage)
7.
Under which category do you intend to apply?
Agricultural Use: __________
Agricultural Reserve: __________
Forest Reserve: __________
(PLEASE READ THE FOLLOWING DEFINITIONS BEFORE CHOOSING THE APPROPRIATE CATEGORY.)
Agricultural Use: Land which is used for the purpose of producing an agricultural commodity, such land was devoted to agricultural
use the preceding three years and is not less than ten contiguous acres in area or has an anticipated yearly gross income of at least
$2000 or when devoted to and meets the requirements and qualifications for payments or other compensation pursuant to a soil
.
conservation program under an agreement with an agency of the Federal Government
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