Form Ab-13 Nonproductive, Patented Mining Claim Application 15-6-133(1)(B), Mca
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1
2MONTANA
CLEAR FORM
AB-13
Rev 07 12
Geocode _____________________________________________
Assessment Code ______________________________________
Nonproductive, Patented Mining Claim Application
15-6-133(1)(b), MCA
This request must be returned to the local Department of Revenue offi ce on or before the fi rst Monday in June of
the current tax year, or 30 days after the date on the assessment notice, whichever is later. You can fi nd contact
information for your local Department of Revenue offi ce by visiting revenue.mt.gov or by calling toll free (866) 859
2254 (in Helena, 444-6900).
Applicant Name ______________________________________________________Date ____________________
Mailing Address ______________________________________________________________________________
City __________________________________________ State ______________ Zip ______________________
Phone Number ____________________ Owner ______________________ Agent _______________________
Property Legal Description (Attach additional pages if more room is needed.)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Section 1 – Qualifying Criteria
1. Does the land meet the defi nition of being “nonproductive”? (See defi nition on reverse side.)
Yes
No
If no, why not? ___________________________________________________
2. Is the land described on the application a patented mining claim?
Yes
No
3. Is the land described located outside the limits of an incorporated city or town?
Yes
No
4. In the case of county-municipal consolidation, was the described land located outside the
limits of the municipality prior to the consolidation?
Yes
No
5. Is the applicant the owner of record as indicated by the tax roll of the county?
Yes
No
Section 2 – Qualifying Criteria
6. Has a certifi cate of survey been fi led on the land described on the application?
Yes
No
7. Are any agricultural commodities grown on the land described on the application?
Yes
No
8. Is any of the surface of the described land leased for a recreational, commercial, residential,
industrial, or agricultural use?
Yes
No
9. Is the topography of the property so severe that it precludes development for any purpose
other than mining?
Yes
No
If yes, describe the severity and why other forms of development could not take place.
_________________________________________________________________________
10. Is there a covenant or ordinance that restricts the land described on the application
from mining?
Yes
No
11. Is any mining activity currently taking place on the land described on the application
from mining?
Yes
No
If yes, please describe the activity. ______________________________________________
12. Are there any improvements (buildings or structures) located on and used in the mining
activity operation of the described land?
Yes
No
If yes, how many total acres of land are beneath all the improvements used in the operation
of the mining activity and are necessary for the use of those improvements? ________ acres
Section 3 – Signature
Signature of Applicant ___________________________________________________________
Date signed ___________________________________________________________________
I affi rm that the information provided in this application form is true and correct.
If you do not agree with our determination regarding this application, you will need to fi le an appeal in writing
(15-15-101, MCA).
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