Form Pa-9 - Certification Of Yield Taxes Assessed Page 3
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1
2
3CITY/TOWN
PAGE
DATE
#1
#4
#5
#7
#8
#9
#10
#6
NUMBER OF
STUMPAGE
TOTAL
CHECK ONE
SPECIES
TAX AT 10%
NAME OF OWNER
MBF, TNS, CDS
MBF TNS
CDS
VAL. ASSESSED
ASSESSED VAL.
TOTAL TAX
WHITE PINE
HEMLOCK
DUE ON THIS
RED PINE
OPERATION
SPRUCE & FIR
HARD MAPLE
WHITE BIRCH
#2
YELLOW BIRCH
(NAME) AND/OR TAX MAP NO.
(TOTAL OF COL. #9)
OAK
by which lot was designated in
ASH
Notice of Intent
BEECH & S. MAPLE
PALLET/TIE LOGS
MAP #
LOT #
OTHERS: SPECIFY
SPRUCE & FIR
$
HARDWOOD & ASPEN
#3
PINE
OPERATION NUMBER
HEMLOCK
TOTAL TREE CHIPS
BIRCH BOLTS
CORDWOOD/FUELWOOD
CITY/TOWN
PAGE
DATE
#1
#4
#5
#7
#8
#9
#10
#6
NUMBER OF
CHECK ONE
STUMPAGE
TOTAL
SPECIES
NAME OF OWNER
TAX AT 10%
MBF, TNS, CDS
MBF TNS
CDS
VAL. ASSESSED
ASSESSED VAL.
TOTAL TAX
WHITE PINE
HEMLOCK
DUE ON THIS
RED PINE
OPERATION
SPRUCE & FIR
HARD MAPLE
#2
WHITE BIRCH
YELLOW BIRCH
(NAME) AND/OR TAX MAP NO.
(TOTAL OF COL. #9)
OAK
by which lot was designated in
ASH
Notice of Intent
BEECH & S. MAPLE
PALLET/TIE LOGS
MAP #
LOT #
OTHERS: SPECIFY
SPRUCE & FIR
$
#3
HARDWOOD & ASPEN
PINE
OPERATION NUMBER
HEMLOCK
TOTAL TREE CHIPS
BIRCH BOLTS
CORDWOOD/FUELWOOD
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