Form Cr-Th1 - Sustainable Forest Incentive Act Enrollment Application - 2014 Page 2
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2014 SFIA Enrollment Application (continued)
Name of landowner or business
Social Security, federal ID or Minnesota ID number
SECTION 3 (con’t.). Provide the following information for each parcel of land you wish to enroll. If you fail to provide the required infor-
mation, including the number of eligible acres for each parcel, your application will be delayed or denied.
A
B
C
D
Code for
Covenant Recording Number
Property Identification Number (PID)
Number of Eligible Acres
Minnesota County
(attach a copy of the covenant, including
(The PID is not the legal description. Attach a copy
(separately list for each parcel;
(3-digit code from instructions)
Exhibits A and B, for each parcel)
of your property tax statement for each parcel)
round to nearest whole acre)
Attach a separate CR-TH1, page 2, if needed.
Subtotal from page 1 . . . . .
Total acres to be enrolled . . . . .
SECTION 4 — Signatures
It is the applicant’s or the authorized representative’s responsibility to have the approved plan writer sign, date and provide his or her
SFIA ID number before submitting. The application will be denied if the requested information and signatures are not provided. Mak-
ing false statements on this application is punishable by law. Civil and/or criminal penalties may apply for filing a false or fraudulent
application.
Plan writer (signature and SFIA ID number are required): I attest that the forest management plan(s) on the above land was devel-
oped within the last 10 years, and I have verified the number of eligible acres provided for each parcel is correct.
Approved plan writer’s name (first, middle and last name). If more than one, attach separate sheet.
SFIA ID number
Approved plan writer’s signature
Date
Daytime phone
Applicant or authorized representative (signature required): I declare that this form is correct and complete to the best of my
knowledge and belief. I own or I am an authorized representative of the entity that owns the land and I agree to follow the land’s
forest management plan and all provisions of the Sustainable Forest Incentive Act. I also claim that no delinquent property taxes are
due.
Signature of applicant or authorized representative
Date
Daytime phone
You must attach copies of the recorded covenant(s), including Exhibit(s) A and B, each parcel’s 2013 property tax statement
and the forest management plan map or eligible acres map.
Keep complete copies of all documents, including your application, for future reference. Mail this application and all required
attachments no later than Sept. 30, 2014, to: Minnesota Revenue, Mail Station 3340, St. Paul, MN 55146-3340.
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