Is this farm in the Century Farm program? Office Use Only: Database________
No Yes Web________
Certificate________
Mailed ________
N.C. BICENTENNIAL FARM APPLICATION
Please print clearly and fill in all blanks.
COUNTY____________
CURRENT OWNER INFORMATION
NAME _______________________________________________________________________
MAILING ADDRESS ___________________________________________________________
CITY___________________________________ ZIP CODE___________________________
PHONE number________________________ EMAIL ________________________________
FARM INFORMATION
FARM NAME (will be listed on certificate) __________________________________________
PROPERTY ADDRESS__________________________________________________________
______________________________________________________________________________
County tax parcel number of oldest land _____________________________________________
PROOF OF 200 YEARS OF CONTINUOUS FAMILY OWNERSHIP
Name
Dates of ownership
(From year - year)
Relation to original owner
Original Owner
Next Owner
Next Owner
Next Owner
Next Owner
Next Owner
Next Owner
The above evidence of continuous family ownership for the past 200 years or more is
taken from one or more of the following records. (Check all that apply.)
Abstract of Title Land Patent Original Deed
County Land Records Other _____________________________________________
I hereby certify the information listed below is correct to the best of my knowledge and belief.
WITNESS SIGNATURE_____________________________________DATE__________
OWNERS SIGNATURE_____________________________________DATE__________
click to sign
signature
click to edit
click to sign
signature
click to edit
REQUIREMENTS FOR AWARD
1. Ownership of Property by Family for 200 Years of More: This can be
determined from an abstract of title or original records such as original deed or
land patents. Other authentic land records may be acceptable in some cases.
2. Continuous Family Ownership: The farm (in whole or in part) must have been
in continuous FAMILY OWNERSHIP. Title to the bicentennial property today
must reside in a blood relative of the original owner, or a legally adopted child
of the descendant. Continuous residence in the state or on the property is not
required, but the title to the property must be continuous. An abstract of title is
the best evidence of continuous family ownership.
3. Only One Certificate Issued Per Property: There shall be only one certificate
issued for a piece of property. For example, a descendant may not receive
another certificate if a former owner or relative has already received a
certificate for the same property
.
SEND APPLICATIONS
TO:
NCDA&CS Public Affairs
Division
1001 Mail Service Center
Raleigh, NC 27699-1001
For additional information,
call 919-707-3002.
Please note:
Certificates take 6 to 8 weeks
to process. You will receive a
confirmation email once your
application has been
approved.
N.C. BICENTENNIAL FARM APPLICATION
Historical Information Form (optional)
This form is optional. If you choose to fill it out, you can leave any question blank if you do not wish
to answer or do not know the answer. The answers do not affect your farm’s application status.
Name of farm _______________________________________________
Where did the original owner come from?____________________________
How many acres did the founder own?_______________________
How was the land used by the original owners? (crops grown, livestock raised, timber
production, etc.): ___________________________________________
_______________________________________________________________
How many acres is the farm today?___________________________________
How many acres are still in agricultural use?____________________________
Who is currently using the farm - a family member or renter? ______________
What crops / livestock are raised on the farm today? ____________________
_______________________________________________________________________________________
Are there any of the original or historic structures (including homes) remaining on
the farm? If yes, please indicate what they are and if they are still in use. _______
____________________________________________________________________________________________
Do you have a farmland preservation or conservation easement on your property? Y / N
Feel free to provide any other background information you have about the farm or
any of your ancestors on another sheet of paper.