Form 456 - Special Valuation Application For Agricultural Or Horticultural Use
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TO BE FILED WITH
FORM
Special Valuation Application
THE COUNTY
456
ASSESSOR ON OR
for Agricultural or Horticultural Use
BEFORE JUNE 30
Applicant’s Name
Owner of Record
Street or Other Mailing Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Parcel ID Number
County
Legal Description of Land
Description of Agricultural or Horticultural Use
ACRES DEVOTED TO AGRICULTURAL OR HORTICULTURAL USE
1 Total number of acres in legal description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2 Number of acres not devoted to agricultural or horticultural use. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
0.00
3 Number of acres devoted to agricultural or horticultural use (line 1 minus line 2). . . . . . . . . . . . . . . .
3
Under penalties of law, I declare that I have examined this application and that it is, to the best of my knowledge and belief, true and
correct. I also declare that I am entitled to a special valuation of my property based on agricultural and horticultural use.
sign
here
Signature of Applicant or Applicant’s Authorized Representative
Date
FOR COUNTY ASSESSOR’S USE ONLY
APPROVED
COMMENTS:
DISAPPROVED
Signature of County Assessor
Date
Nebraska Department of Revenue Form Number 96-257-2006 Rev. 2-2013
Authorized by Neb. Rev. Stat. § 77-1345
Supersedes 96-257-2006 Rev. 2-2010
RETAIN A COPY FOR YOUR RECORDS.
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