THIS FORM APPROVED BY THE COMMISSIONER OF REVENUE
State Tax Form CL-3
The Commonwealth of Massachusetts
Revised 9/2008
Name of City or Town
Office of the Board of Assessors
Classified Forest-Agricultural or Horticultural-Recreational Land Tax Lien
The Board of Assessors in the city/town of _________________________ hereby states it has accepted and approved the
application of
owner(s) of the real property described below, for the valuation, assessment and taxation of that property as classified
forest agricultural or horticultural recreational land under the provisions of General Laws Chapter 61
61A 61B . This classification is effective as of January 1, for the fiscal year beginning July 1, .
DESCRIPTION OF PROPERTY
(The description must be sufficiently accurate to identify the property. In the case of registered land, the Certificate of
Title Number and the Registry Volume and Page must be given.)
This statement made on the ________________ day of _____________________, ____________ constitutes a lien upon the
property as provided in General Laws Chapter 61, § 2 61A, § 9 61B, § 6 .
Board of Assessors
The Commonwealth of Massachusetts
ss.
On this _____ day of _______________, ______, before me, the undersigned notary public, personally appeared
_______________________________________________________________________, as Board of Assessors for the city/town
of ____________________________________ , proved to me through satisfactory evidence of identification, which were
_____________________________________, to be the persons whose names are signed on the preceding document in my
presence, and acknowledged to me that they signed it voluntarily for its stated purpose.
Notary Public
My commission expires
