F
Current Use Program
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V
ermont
CU-302
Additional Owners Form for Use Value Appraisal Application
SECTION A
APPLICATION INFORMATION from Form CU-301
Owner #1 ____________________________________________________ Owner #1 SSN or FEIN _______________________
Town ___________________________ SPAN ______________________________
SECTION B
ADDITIONAL LANDOWNERS
List all persons holding record title to this parcel. Select ONE owner as the primary contact. Owner #1 from Form CU-301 will be used if none is selected.
Owner #4 Social Security Number or FEIN
Owner #5 Social Security Number or FEIN
Owner #6 Social Security Number or FEIN
Owner #4 Name
Owner #5 Name
Owner #6 Name
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 2
Mailing Address, Line 2
Mailing Address, Line 2
City, State, ZIP
City, State, ZIP
City, State, ZIP
e-mail
e-mail
e-mail
Primary Phone
Primary Phone
Primary Phone
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
c Yes
c No
c Yes
c No
c Yes
c No
Owner #7 Social Security Number or FEIN
Owner #8 Social Security Number or FEIN
Owner #9 Social Security Number or FEIN
Owner #7 Name
Owner #8 Name
Owner #9 Name
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 2
Mailing Address, Line 2
Mailing Address, Line 2
City, State, ZIP
City, State, ZIP
City, State, ZIP
e-mail
e-mail
e-mail
Primary Phone
Primary Phone
Primary Phone
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
c Yes
c No
c Yes
c No
c Yes
c No
Owner #10 Social Security Number or FEIN
Owner #11 Social Security Number or FEIN
Owner #12 Social Security Number or FEIN
Owner #10 Name
Owner #11 Name
Owner #12 Name
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 1
Mailing Address, Line 2
Mailing Address, Line 2
Mailing Address, Line 2
City, State, ZIP
City, State, ZIP
City, State, ZIP
e-mail
e-mail
e-mail
Primary Phone
Primary Phone
Primary Phone
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
Is this owner the PRIMARY CONTACT?
c Yes
c No
c Yes
c No
c Yes
c No
SECTION J
CERTIFICATION To be completed by all owners of record - ALL OWNERS MUST SIGN - if signature by other than owner(s), attach copy of
recorded power of attorney or other recorded authorization.
I hereby certify that the information provided in this form is true and accurate to the best of my knowledge.
I intend to have all of my property described on this application appraised at use value except those portions specifically excluded.
I acknowledge that I, my heirs and assigns are subject to the provisions of 32 V.S.A. Chapter 124 and the rules and regulations and use values as adopted
and prescribed by the Current Use Advisory Board, the Commissioner of Taxes, and state statutes.
When this application is signed by the owner(s) and approved by the state, the state shall record a lien in the land records of the municipality
to secure payment of the land use change tax upon development of the parcel. The lien shall run with the land.
I acknowledge that the Vermont Department of Forests, Parks and Recreation, the Vermont Department of Taxes, and their employees or duly authorized
representatives have the right to enter the property at anytime without prior notice for the purposes of ensuring compliance with the Use Value
Appraisal Program requirements.
Owner #4 Name: _________________________________
Signature: ______________________________________
Date: _____________
Owner #5 Name: __________________________________
Signature: ______________________________________
Date: _____________
Owner #6 Name: __________________________________
Signature: ______________________________________
Date: _____________
Owner #7 Name: __________________________________
Signature: ______________________________________
Date: _____________
Owner #8 Name: __________________________________
Signature: ______________________________________
Date: _____________
Owner #9 Name: __________________________________
Signature: ______________________________________
Date: _____________
Owner #10 Name: _________________________________
Signature: ______________________________________
Date: _____________
Owner #11 Name: _________________________________
Signature: ______________________________________
Date: _____________
Owner #12 Name: _________________________________
Signature: ______________________________________
Date: _____________
Attach to Use Value Appraisal Application Form (CU-301) and include an additional $10.00.
Form CU-302
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