Agricultural Use Questionnaire For 1-D-1 Agricultural Land Form Page 2
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3STEP 7: Land use.
Do you use your land yourself or lease it to a tenant?
SELF
LEASE
If your answer is “LEASE,” please provide the following information. Also, attach a copy of the lease
.
(if available)
This property is leased to: ___________________________________________________________________________________
Address:
___________________________________________________________________________________
City, State & ZIP code:
___________________________________________________________________________________
Telephone number:
___________________________________________________________________________________
STEP 8: Lease agreements.
If there is no written lease, what are the lease agreements?
(SKIP THIS QUESTION if you are submitting or have already submitted a copy of your current lease agreement(s).)
A.
Cash:
____________
(Amount per acre: ____________ )
B.
Number of years: ____________
C. Other terms:
___________________________________________________________________________________
___________________________________________________________________________________
STEP 9: Hunting use.
Is the property leased for hunting?
YES
NO
If your answer is “YES,” please provide a copy of the lease or lease agreement.
STEP 10: Additional acreage.
Do you or your tenant lease or use additional acreage for the same agricultural purpose?
YES
NO
If your answer is “YES,” please provide the size, location, and property owner’s name of this additional acreage.
Property size:
___________________________________________________________________________________
Property location:
___________________________________________________________________________________
Property owner’s name:
___________________________________________________________________________________
STEP 11: Land sales activity.
Have you sold or purchased any land in the past year?
YES
NO
If your answer is “YES,” please provide the following information:
Purchaser’s name: ____________________________________
Acres sold:
____________
Sales price:
____________
Acres purchased: ____________
Sales price:
____________
STEP 12: Signature and affirmation.
ANY PERSON WHO MAKES A FALSE ENTRY UPON THE FOREGOING RECORD SHALL BE SUBJECT TO THE PENALTIES SET
FORTH IN SECTION 10 OF THE TEXAS PENAL CODE.
I CERTIFY THAT THE INFORMATION GIVEN ON THIS QUESTIONNAIRE IS TRUE AND CORRECT.
____________________________________________________________
____________________________________
Applicant’s Signature
Date
____________________________________________________________
____________________________________
Printed Name
Telephone Number
(including area code)
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