675 East 500 South #500
Salt Lake City, UT 84102-2818
Telephone No. (801)538-5100
Fax No. (801)355-0922
Web site: trustlands.utah.gov
Date: ____________________
LEASE APPLICATION SUPPLEMENTAL INFORMATION
Name: ________________________________
Address: ______________________________
______________________________
City: _________________________________
State: ________ Zip Code: _____________ Phone: ________________
Requested Lease Term: ____________ Years
Intended Use of the property:
Please list or provide a schedule describing when any required improvements will be constructed or developed:
Please describe your experience in performing similar or related activities:
Please list your expected costs/expenses to fully develop the property:
Please outline your anticipated revenues/return to Trust Lands Administration:
Please outline your ability to perform on this lease (financial ability, technical or professional experience, etc.):
Form 2330 Revised 05/2011