Form Ptd-Ag - Affidavit For Agricultural Land Classification
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1WYOMING DEPARTMENT OF REVENUE
AFFIDAVIT FOR AGRICULTURAL LAND CLASSIFICATION
Assessment Year:
Owner Name(s): __________________________________ Mailing Address: ________________________________________
Legal Description of Property (if lengthy, please attach):__________________________________________________________
Parcel Number(s):_________________________________________________________________________________________
Wyoming statute provides that contiguous or noncontiguous parcels of land under one (1) operation owned or leased shall qualify for
classification as agricultural land if the land meets each of the following four qualifications (initial all that apply):
1. _____ The land is presently being used and employed for an agricultural purpose. Initial the applicable classification:
______ Cultivation of the soil for production of crops
______ Production of timber products or grasses for forage
______ Rearing, feeding, grazing or management of livestock
2._____ The land is not part of a platted subdivision. Pursuant to §39-13-103(b) (x) (B) (II) individual subdivision parcels of thirty-
five (35) acres or more “which otherwise qualifies as agricultural land” may be considered for agricultural classification.
3.
Initial the applicable statement:
_____
The land is not leased land and the owner has derived annual gross revenues of not less than five hundred dollars
($500.00) from the marketing of agricultural products from the subject land.
_____
The land is leased and the lessee has derived annual gross revenues of not less than one thousand dollars ($1,000.00)
from the marketing of agricultural products. The applicant must provide name and address of lessee.
Lessee Name: ___________________________________________________________________________________________
Mailing Address: ________________________________________________________________________________________
4._____ The land has been used consistent with the land’s size, location and capability to produce as an agricultural operation as
defined by Department of Revenue Rules and the Mapping & Agricultural Manual as published by the Department of
Revenue (please initial).
If the land has not met the requirements of 3 and 4 above, I state that at least one of the following occurred (initial all that apply).
Please attach an explanation of all that apply.
______ The land has experienced an intervening cause of production failure beyond my control.
______ I have caused a marketing delay for economic advantage.
______ The land participates in a bona fide conservation program in which case proof by an affidavit showing qualifications
in a previous year shall suffice.
______ A crop has been planted that will not yield an income in the taxable year.
I
___________________________________, the owner(s) of the land described above, do solemnly swear (or affirm) that land
contained in the legal description noted above has met the requirements of §39-13-103(b) (x) (B) which are outlined in this form.
Signature(s):______________________________________________________
Date:
__________________________
Printed Name(s): __________________________________________________
Phone: __________________________
State of Wyoming
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a.
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Subscribed and sworn before me this ______ day of ______________________________
County of _______________)
20_____ , by __________________________________________________
______________________________________Notary Public
My Commission expires: _____________________________
Pursuant to §39-1-103(b) (x) (C)... “When deemed necessary, the county assessor may require further supporting documentation.”
PTD-AG
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