STATE of MARYLAND, DEPARTMENT of ASSESSMENTS and TAXATION APPLICATION FOR AGRICULTURAL USE ASSESSMENT
DISTRICT ____________________ ACCOUNT NO._________________
1. Name of owner(s):______________________________________________ 2. Is owner age 70 or older? _______ Disabled? __________ 3. Mailing Address:________________________________________________ ______________________________________________________________ ______________________________________________________________ 4. Telephone Number:______________________________________________ 5. Current Use of Land: 6. Acreage in crops (by type):__________ Acreage in pasture:__________ Acreage in a government program:__________ Acreage in woodland: ______________. Name of private or governmental forestry program that the tract is under:_________________________ 7. Number of livestock or poultry (by type):_________________ 8. Amount of last harvest for each crop:_________________________________ 9. Gross sales last year if farm is under five (5) acres: A. Crops: $ _________________ B. Livestock: $ _______________ C. Livestock Products: $ ______________ 10. Name and address of person conducting farm operation if other than owner: _______________________________________________________________ _______________________________________________________________ 11. Is this acreage adjacent to other farm property which you own or which is owned by an immediate family member? Yes ______ No ______ If yes, give name of family member _________________________________ relationship__________ ___________________________. 12. Did you complete Schedule F in your Federal Income Tax Return?__________ I certify that the above statements are true and correct and that I understand it is my responsibility to notify the Supervisor of Assessments if agricultural use of the land described above is discontinued. Signature of Owner: _______________________________ Date: ______________
CAUTION: A transfer of any portion of the above-described land may require imposition of an agricultural transfer tax. SEE TAXPROPERTY ARTICLE, SECTION 13-301 - 13-308, ANNOTATED CODE OF MARYLAND. This form seeks information for the purpose of an agricultural use assessment on the indicated property. Failure to provide this information will result in denial of your application. However, some of this information would be considered a "personal record" as defined in State Government Article, § 10-624. Consequently, you have the statutory right to inspect your file and to file a written request to correct or amend any information you believe to be inaccurate or incomplete. Additionally, personal information provided to the State Department of Assessments and Taxation is not generally available for public review. However, this information is available to officers of the State, county, or municipality in their official capacity and to taxing officals of any State or the federal government, as provided by statute. Additionally, if your property would be used by the State Department of Assessments and Taxation as a comparable for purposes of establishing the value of another property in a hearing before the Maryland Tax Court, the requested information or a portion thereof, may have to be provided to the owner of that other property.