Fillable Cu 12 Form Summary Forest Stewardship Plan Current Use Assessment (TOWN OF ANDOVER)

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Cu 12 Form Summary Forest Stewardship Plan Current Use Assessment (TOWN OF ANDOVER)

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NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CU-12
FORM
SUMMARY OF FOREST STEWARDSHIP PLAN
FOR CURRENT USE ASSESSMENT
Page 1 of 3
CU-12
Ver 1.3 9/2019
FORESTER PRINTED NAME AND SIGNATURE (In black or dark blue ink) FORESTER LICENSE # (IF EXEMPT SO STATE)
Reason for denial:
(a) Required statement of forestry accomplishments pursuant to Cub 304.07 (a)(1)
(b) Required map is attached for the parcel/tract pursuant to Cub 301.11 and Cub 304.07 (a) (2)
(c) Required summary of stewardship plan information pursuant to Cub 304.07 (a)(3)c
NEW APPLICATION UPDATE
TAX YEAR APPLIED FOR: April 1,
STEP 1 - PROPERTY OWNER:
(b) TOTAL ACRES/PARCEL/TRACT
(c) TAX MAP AND LOT # TAX MAP AND LOT # TAX MAP AND LOT # TAX MAP AND LOT #
TOTAL ACRES IN CU # ACRES IN FOREST STEWARDSHIP TOTAL ACRES NOT IN CU
MAILING ADDRESS
STEP 2 - IDENTIFICATION OF PROPERTY TO BE ENROLLED IN FOREST STEWARDSHIP ASSESSMENT
NOTE: Parcels must be contiguous and in common ownership. Non-contiguous lots must be on a separate application.
STEP 3 - DOCUMENTATION FOR FOREST STEWARDSHIP ASSESSMENT
STEP 4 - SIGNATURES OF PROPERTY OWNER(S) AND FORESTER
I/WE certify that the land indicated above qualifies for forest stewardship assessment under the New Hampshire Statute RSA 79-A and
that failure to comply with the requirements may result in reclassification of the forest land.
OWNER PRINTED NAME AND SIGNATURE (In black or dark blue ink)
DATE
DATE
STEP 5 - APPROVAL/DENIAL BY MUNICIPAL ASSESSING OFFICIALS
TYPE OR PRINT NAME (in black or dark blue ink)
SIGNATURE (in black or dark blue ink)
DATE
TYPE OR PRINT NAME (in black or dark blue ink)
SIGNATURE (in black or dark blue ink) DATE TYPE OR PRINT NAME (in black or dark blue ink)
SIGNATURE (in black or dark blue ink)
DATE
TYPE OR PRINT NAME (in black or dark blue ink)
SIGNATURE (in black or dark blue ink)
DATE
TYPE OR PRINT NAME (in black or dark blue ink)
SIGNATURE (in black or dark blue ink) DATE
APPROVED DENIED
STEP 6 - SIGNATURES OF A MAJORITY OF THE MUNICIPAL ASSESSING OFFICIALS
MUNICIPALITY STATE
ZIP CODE
LAST NAME/CORPORATION/TRUST NAME FIRST NAME/CORPORATION/TRUST NAME
INITIAL
MUNICIPALITY (a) ACCESSIBLE STREET LOCATION
COUNTY
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CU-12
FORM
SUMMARY OF FOREST STEWARDSHIP PLAN
FOR CURRENT USE ASSESSMENT
Page 2 of 3
CU-12
Ver 1.3 9/2019
WHO MUST FILE
A landowner who requests to have their forest land assessed as "Forest Land with Documented Stewardship", who does not have a New Hampshire
tree farm confirmation letter, documentation of equivalent tree farm certification, or a forest stewardship plan that meets the requirements contained
in Cub 304.07 (a)(3) c., may complete and file Form CU-12 with the municipal assessing officials. The Form CU-12 is not a requirement for the
"unmanaged" Forest Land assessment category.
WHEN TO FILE
The Form CU-12 may be filed with the municipal assessing officials at the time of the original application for current use assessment, at any time after
enrollment into current use, or used to update the forestry stewardship plan. After the municipal assessing officials have approved the assessment as
"Forest Land with Documented Stewardship", the municipal assessing officials may require that the landowner update their forestry stewardship
documentation at intervals of five or more years.
WHAT TO FILE
A landowner who completes the Form CU-12 to have their forest land assessed as "Forest Land with Documented Stewardship", must provide the
following supporting documentation:
* A statement of current and past forestry accomplishments, including an explanation of deviations from the objectives of the past plan
* A map as required under Cub 301.11;
* A summary of the forest stewardship plan that includes;
1. A statement of forest stewardship objectives;
2. Current forest stand type descriptions;
3. A summary of the current management plan and prescriptions as required under Cub 304.07 (a)(3) c.3.;
4. A boundary line maintenance schedule; and
5. An access development and road maintenance plan, if applicable.
A landowner shall sign and date the completed Form CU-12 as follows:
1. The completed Form CU-12 shall contain the printed name and signature of the owner and, the printed name and signature of the
forester including the New Hampshire licensed forester number; or
2. The completed Form CU-12 shall contain the signature of the owner and, if the owner is exempt pursuant to RSA 310-A:9, the owner
shall signify by writing "Exempt" in the space provided for the forester license number.
WHERE TO FILE
The completed signed Form CU-12 and accompanying documentation must be filed with the municipal assessing officials in the municipality in which
the property is located.
APPEAL
Pursuant to RSA 79-A:9 and RSA 79-A:11, if the municipal assessing officials deny in whole or part any application for Current Use, or grant a different
Current Use classification than that applied for, the applicant may appeal to either the New Hampshire Board of Tax and Land Appeals (BTLA)or to the
Superior Court. The appeal must be filed within six months after notification of such action by the municipal assessing officials.
ADA
Individuals who need auxiliary aids for effective communication in programs and services of the department are invited to make their needs and
preferences known to the New Hampshire Department of Revenue Administration.
NEED HELP?
Contact the Municipal and Property Division at (603) 230-5950.
INSTRUCTIONS
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CU-12
FORM
SUMMARY OF FOREST STEWARDSHIP PLAN
FOR CURRENT USE ASSESSMENT
Page 3 of 3
CU-12
Ver 1.3 9/2019
INSTRUCTIONS continued
LINE-BY-LINE FORM INSTRUCTIONS
STEP 1
Indicate the tax year for which the Form CU-12 is being submitted and indicate whether the owner is enrolling the land into forest stewardship or is
providing an update to the existing forest stewardship information. Provide the name and address of the current owner of the property for which
the forest stewardship current use assessment applies. If there is more than one owner, submit a supplemental list of additional names and
signatures.
STEP 2
(a) Provide the name of the nearest street from which the property may be accessed, the name of the municipality, and the name of the county in
which the property is located.
(b) Provide the total number of acres in the parcel or tract of land as referenced by deed, survey, or the municipal property assessment record(s).
Provide the total number of acres of the parcel or tract of land that is presently being assessed as current use land; the total number of acres to be
assessed in forest stewardship; and the total acres not in current use.
(c) Provide the municipal tax map and lot number for the parcel, or for each contiguous parcel in the tract of land, which is to be assessed in forest
stewardship.
STEP 3
(a) Provide acknowledgment by checking the box that the required statement of forestry accomplishments has been submitted.
(b) Provide acknowledgment by checking the box that the required map has been submitted.
(c) Provide acknowledgment by checking the box that the required summary of stewardship plan information has been submitted.
STEP 4
Provide the property owner printed name, signature, and date of their signature or, the printed name, signature, and date of signature by an agent
with power of attorney including a copy of the agent's executed power of attorney. Provide the forester's printed name, signature, forestry license
number, and date of their signature or an indication that the person is exempt from licensure pursuant to RSA 310-A:98.
STEP 5
The Municipal Assessing Officials shall review the submitted Form CU-12 and accompanying information and check the appropriate box indicating
whether the request of forest stewardship current use assessment was approved or denied. If the Municipal Assessing Officials have indicated that
the request has been denied, the Municipal Assessing Officials shall specify the reason(s) for denial.
STEP 6
Signature of a majority of the Municipal Assessing Officials and date of signature.
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Cu 12 Form Summary Forest Stewardship Plan Current Use Assessment (TOWN OF ANDOVER)

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Completed 14 July 2020

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