Indicate gross income from each crop that was sold, or had it been sold, for the past three years. If land is rented, you
may need to contact the farmer for income. NOTE: DO NOT INCLUDE RENT; only income from crops, plants or animals.
Is this farm in an active CRP program? YES_____ NO_____
Was the income listed above reported for NC income tax for the owner? YES _____ NO _____ If NO, please explain or
give name of person reporting income: __________________________________________________________________________
If this tract is leased or rented, give the name and address of tenant: _______________________________________________
______________________________________________________________________________________________________________
Are you currently actively engaged in the commercial production of timber and forest products under a sound
management program to obtain the greatest net return from the land consistent with its conservation and long-term
improvement? YES _____ NO _____
To qualify for use value assessment, this forestland must have a written management plan prepared by a certified
forester and the plan must be followed. The forestland must be in compliance with a current written sound forest
management plan as of January 1, 2020. *
Attach a copy of your forest plan as part of this application.
Date of current Forestry Management Plan: __________________
1. I have applied to have my land taxed by Randolph County at Present Use Value and that the difference between the tax
at market value and the tax at present use value with interest will be deferred as long as the use of the property meets
the requirements of North Carolina law.
2. If my property becomes ineligible for taxation at present use value that the current year and the three (3) prior years of
deferred taxes and interest will become due immediately.
3. I am required by N.C. General Statute 105-277.5 to report to the tax department during the listing period any changes
that occurred in the past year which could disqualify all or part of the land which is being taxed at present use value.
Failure to report changes may result in a penalty of ten percent (10%) of the total deferred taxes.
4. State law requires the Tax Department to audit my application and the use of my farm to determine if the use
continues to be eligible for deferred taxes and that I will be asked for income and other information periodically as part
of the audit process.
I (we), the undersigned, declare under penalties of law that this application and any attachments hereto have been
examined by me (us) and to my (our) knowledge and belief are true and correct.
*Remember to attach your current forestry management plan and/or Schedule F (whichever applies).
2020
I, THE UNDERSIGNED, CLEARLY UNDERSTAND THAT:
AFFIRMATION (MUST HAVE SIGNATURE OF EACH OWNER) - use blank page for additional signatures
*Attach a copy of your most recent Schedule F (Form 1040) showing your reported farm income and expenses*
2017
2018
2019
SECTION B - AGRICULTURE & HORTICULTURE USE
# acres in
other
products
