Owner Name(s): Mailing Address:
Legal Description of Property (if lengthy, please attach):
Wyoming statute provides that contiguous or noncontiguous parcels of land under one (1) operation owned or leased shall qualify for classification as
agricultural land if the land meets each of the following four qualifications (initial all that apply):
1. Initial the applicable classifications.
The land is presently being used and employed for an agricultural purpose.
Cultivation of the soil for production of crops
Production of timber products or grasses for grazing
Grazing of livestock
2. The land is not part of a platted subdivision. Pursuant to §39-13-103(b) (x) (B) (II) individual subdivision parcels of thirty-five
(35) acres or more “which otherwise qualifies as agricultural land” may be considered for agricultural classification.
3. Initial the applicable statement:
The land is not leased land and the owner has derived annual gross revenues of not less than five hundred dollars ($500) from the
marketing of agricultural products from the subject land.
The land is leased and the lessee has derived annual gross revenues of not less than one thousand dollars ($1,000) from the
marketing of agricultural products. The applicant must provide name and address of lessee.
Lessee Name: Phone No.
Mailing Address:
4. The land has been used consistent with the land’s size, location and capability to produce as an agricultural operation.
If the land has not met the requirements of 3 and 4 above, I state that at least one of the following occurred.
Initial all that apply. Attach explanation
The land has experienced an intervening cause of production failure beyond control.
I have caused a marketing delay for economic advantage.
The land participates in a bona fide conservation program in which case proof by an affidavit showing qualifications in a
previous year shall suffice.
A crop has been planted that will not yield an income in the taxable year.
I the owner(s) of the land described above, do solemnly swear (or affirm) that land contained in the legal
description noted above has met the requirements of §39-13-103(b) (x) (B) (II) which are outlined in this form.
Signature(s): Date:
Printed Name(s): Phone:
State of )
)ss Subscribed and sworn before me this day of , 20 by
County of )
Notary Public
My Commission Expired: (Seal)
Pursuant to §39-13-103(b) (x) (C)… “When deemed necessary, the county assessor may further require supporting documentation”
*Please supply supporting documents for the sale of livestock, timber or crops. (i.e. Individual sales, or sale barn receipts.)
**Lease payments do not count towards, or qualify for the Ag Classification.
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