Form 7-2180 - Certification Of Individual'S Landholdings - 2016 Page 3

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FORM 7-2180 (2016)

LANDHOLDER’S NAME:

13.

LAND YOU DIRECTLY LEASE FROM ANOTHER PARTY

List all irrigable and/or irrigation land parcels westwide that you lease from another party. Include land directly leased by any entity in which you own 100-percent interest. Do not include land you lease from a

public entity here. Such land is to be included under item 10. Include the sublessor’s name and the landowner’s name in column (d) if you sublease from a sublessor. Include the farm operator's name in

column (d) if the land is operated by a farm operator. You must complete all columns except column (g) if you sublease land parcels to others and provide the sublessee’s name and the landowner’s name in

column (d). For additional space, use Form 7-21CONT-L or your own similar continuation sheet.

Lease Information

(d)

(check one)

Landowner's Name

(g)

(a)

(b)

(f)

(If the land has been subleased or is

Number of

(e)

District Name

Legal Description of Land Parcel(s) or

Ending

operated by a farm operator, see the

Acres

Starting Date

Assessor's Parcel Number(s)

Date

above instructions for other needed names.)

(m/d/yr)

14.

TOTAL NUMBER OF ACRES YOU DIRECTLY LEASE

15.

LAND YOU INDIRECTLY OWN OR LEASE THROUGH OTHER ENTITIES

List all entities that hold irrigable and/or irrigation land in which you own a part (less than 100-percent interest, and all trusts and estates in which you own up to and including 100-percent interest. Do not

include land directly held by any entity in which you own 100-percent interest. Instead, include that land in item 10 or item 13 as appropriate. Include land indirectly held by any entity in which you own 100-

percent interest. You will have to enter an entity’s name on more than one line if it holds irrigable and/or irrigation land in more than one district. Obtain a copy of the entity’s completed Form 7-2181 or Form 7-

2191, or a copy of the trust’s or estate’s completed Form 7-21TRUST to ensure the accuracy of the information you provide. For land held by a dependent, include the name of the dependent after the name of

the entity. For additional space, use Form 7-21CONT-I or your own similar continuation sheet.

(f)

(h)

(e)

(i)

Owned

(g)

Double-Counting

(d)

Number of

Leased

Acreage