Application for Agriculture, Horticulture, and
Forestry Present-Use Value Assessment
(G.S. 105-277.2 through G.S. 105-277.7)
County of , NC Tax Year
Web-Fill
3-18
Full Name of Owner(s)
Mailing Address of Owner
City
Zip CodeState
Home Telephone Number Work Telephone Number Cell Phone NumberExt.
AV-5
TOTAL
ACRES
Enter the Parcel Identication Number, acreage breakdown, and acreage total for each tax parcel included in this application:
PARCEL ID
OPEN LAND
in Production
OPEN LAND
not in
Production
WOOD
LAND
WASTE
LAND
CRP
LAND
HOME
SITE
Comments:
County:
This application is for: (check all that apply)
HORTICULTUREAGRICULTURE (includes Aquaculture) FORESTRY
OTHER
(Describe in
Comments)
Yes No Does the applicant own property in other counties that is also in present-use value and is within 50 miles of this property? If
YES, list the county or counties and parcel identication number(s):
Parcel ID:
IMPORTANT!
AGRICULTURE and HORTICULTURE applications with LESS than 20 acres of woodland generally need to complete PARTS 1,
2, and 4.
AGRICULTURE and HORTICULTURE applications with MORE than 20 acres of woodland generally need to complete PARTS 1,
2, 3, and 4.
FORESTRY applications need to complete PARTS 1, 3, and 4.
ADDITIONALLY, applications for CONTINUED USE of existing present-use value classication need to complete PART 5.
Please contact the Tax Assessor’s ofce if you have questions about which parts should be completed.
Instructions
Application Deadline: This application must be led during the regular listing period, or within 30 days of a notice of a change in valuation, or within
60 days of a transfer of the land.
Where to Submit Application: Submit this application to the county tax assessor where this property is located. County tax assessor addresses
and telephone numbers can be found online at: https://www.ncdor.gov/documents/north-carolina-county-assessors-list. DO NOT submit this
application to the North Carolina Department of Revenue.
- Ofce Use Only:
County: Parcel ID:
0.00
0.00
0.00
0.00
0.00
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PRINT
CLEAR
Page 2, AV-5, Web-Fill, 3-18
Part 1. Ownership
On what date did the applicant become the owner of the property? DATE:
If owned less than four full years on January 1, provide: Name of Previous Owner:
How the Applicant is Related to the Previous Owner:
Yes No Did one of the applicants reside on the property on January 1 of the year for which this application is made?
If YES, provide name of resident:
Yes No Are any of the acres leased out to a farmer? If YES, indicate: Number of acres leased out:
Name of farmer leasing the land: Phone:
b. Husband and Wife (as tenants by the entirety)a. One Individual
Choose the legal form of ownership from “a - e” below, and answer the questions, if any, for that ownership:
c. Business Entity. (Circle one: Corporation, Limited Liability Company, Partnership) List all the direct shareholders, members, or
partners of the business entity and their farming activities:
Member: Farming Activities:
Member: Farming Activities:
Member: Farming Activities:
Member: Farming Activities:
Yes No Are any of the direct shareholders, members, or partners either a business entity or trust (i.e. not an individual)? If YES,
you must attach a breakdown of those business entities or trusts until you reach the individual level of ownership interest
and you must describe those individuals’ farming activities.
Yes No Once you have reached the individual level of ownership interest, are all of the individuals relatives of each other? (See
G.S. 105-277.2(5a) for the denition of relative.)
State the principal business of the business entity:
d. Trust. List the trustee(s), name of the trust, and all of the beneciaries:
Beneciary: Farming Activities:
Beneciary: Farming Activities:
Yes
Yes No
Owner
%
Owner
%
%
%
Owner
Owner
Once you have reached the individual level of ownership interest, are all of the beneciaries either the trust’s creator or
relatives of the creator? (See G.S. 105-277.2(5a) for the denition of relative.)
No Are any of the beneciaries either a business entity or trust (i.e. not an individual)? If YES, you must attach a breakdown
of those business entities or trusts until you reach the individual level of ownership interest and you must describe those
individual’s farming activities.
Beneciary: Farming Activities:
Beneciary: Farming Activities:
Trustee(s):
Name of trust:
e. Tenants in common. List the tenants and their percentage of ownership (round to the nearest 0.1%):
Yes No
Are any of the tenants either a business entity or trust? If YES, you must make a copy of this page for each business
entity or trust. You must complete the business entity section only or trust section only for each tenant, as appropriate,
labeling each copy with the name of the business entity or trust.
The Tax Assessor may contact you for additional information after reviewing this application.
Page 3, AV-5, Web-Fill, 3-18
Part 2. Agriculture and Horticulture
For the past three years and for each tax parcel within the farm unit, enter the agricultural or horticultural products actually produced on the land
and the gross income from the sale of the products, including livestock, poultry, and aquatic species. INCOME INFORMATION IS SUBJECT TO
VERIFICATION.
If payments are received from any governmental soil conservation or land retirement program, indicate the acres and amount of income in the table
below. Provide the name of the program in the Product column.
Do not include income received from the rental of the land. Income must be from the sale of the product.
Parcel ID Product
ONE YEAR AGO 20
Totals
Totals
Totals
Totals
Acres Income
Totals
Product
TWO YEARS AGO 20
Totals
Totals
Totals
Totals
Acres Income
Totals
Product
THREE YEARS AGO 20
Totals
Totals
Totals
Totals
Acres Income
Totals
Yes No If this application covers a horticultural tract used to grow Christmas trees, has a written management plan been
prepared? If YES, attach a copy. If NO, attach a full explanation of your operation that contains at least the following:
year each tract was planted, gross income from each tract, site management practices, number of trees per acre, and
expected date of harvesting for each tract.
If this application covers an aquatic species farming operation, enter the total pounds produced for commercial sale annually
for the last three years: Year 20 : lbs, Year 20 : lbs, Year 20 : lbs
Part 3. Forestry
Consulting ForesterN.C. Division of Forest Resources
Attach a complete copy of your forest management plan. Indicate below who prepared the plan:
Owner Other
Note: The property must be actively engaged in the commercial growing of trees under a sound management program as of January 1
of the year for which application is made.
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0
0
0
0
0
0
0
0
0
0
0
0
0
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Page 4, AV-5, Web-Fill, 3-18
Part 4. Afrmation
Key elements in a written plan for a sound forestland management program are listed below:
1. Management and Landowner Objectives Statement—Long range and short range objectives of owner(s) as appropriate.
2. Location--Include a map or aerial photograph that locates the property described and also delineates each stand referenced in the “Forest
Stand(s) Description/Inventory and Stand Management Recommendations” (item 3 below).
3. Forest Stand(s) Description/Inventory and Stand Management Recommendations -- Include a detailed description of various stands within the
forestry unit. Each stand description should detail the acreage, species, age, size (tree diameter, basal area, heights), condition (quality and
vigor), topography, soils and site index or productivity information. Stand-specic forest management practices needed to sustain productivity,
health and vigor must be included with proposed timetable for implementation.
4. Regeneration-Harvest Methods and Dates--For each stand, establish a target timetable for harvest of crop trees, specifying the type of
regeneration-harvest (clear cut, seed tree, shelter wood, or selection regeneration systems as applicable).
5. Regeneration Technique--Should include a sound proposed regeneration plan for each stand when harvest of nal crop trees is done. Specify
intent to naturally regenerate or plant trees.
NOTE: Forest management plans can and should be updated as forest conditions signicantly change (e.g. change in product class mix as the stand
ages and grows, storm damage, insect or disease attack, timber harvest, thinning, wildre). The county will audit plans periodically and, to remain eligible
for use-value treatment, the plan must be implemented.
AFFIRMATION OF APPLICANT – I (we) the undersigned declare under penalties of law that this application and any attachments
hereto have been examined by me (us) and to the best of my (our) knowledge and belief are true and correct. In addition, I
(we) fully understand that an ineligible transfer of the property or failure to keep the property actively engaged in commercial
production under a sound management program will result in the loss of eligibility. I (we) fully understand that loss of
eligibility will result in removal from the program and the immediate billing of deferred taxes.
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
Part 5. Continued Use (Complete only if the property is currently in Present-Use Value and you are applying for immediate
eligibility under the Continued Use exception. See G.S. 105-277.3(b2)(1) for full details.)
I certify: 1. The property is currently in Present-Use Value.
2. I intend to continue the current use of the land under which it currently qualies.
3. I understand I will be responsible for all deferred taxes due because of any disqualication.
4. I ACCEPT FULL LIABILITY FOR ANY EXISTING DEFERRED TAXES.
Note: If the property is currently in Present-Use Value and liability is not accepted, the full amount of the deferred taxes will
typically be due in the name of the grantor immediately. Liability need not be accepted and no deferred taxes are due for
qualifying transfers pursuant to G.S. 105-277.3(b) and (b1). For example, liability does not need to be accepted for qualifying
transfers to relatives. However, any deferred taxes existing at the time of transfer will remain a lien on the property. Owners
already receiving Present-Use Value on properties not included in this application may wish to review the alternative provisions
of G.S. 105-277.3(b2)(2).
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
Signature of Owner (All tenants of a tenancy in common must sign.) Title Date
FOR OFFICE USE ONLY: APPROVED DENIED BY:_______________________ REASON FOR DENIAL: _________________________________________