FORM
PA-60
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CONSERVATION RESTRICTION ASSESSMENT APPLICATION
PA-60
Rev. 3/13
FOR REGISTER OF DEEDS USE ONLY
PLEASE TYPE OR PRINT
LAST NAME FIRST NAME
STREET ADDRESS
ADDRESS (continued)
TOWN/CITY STATE ZIP CODE
STEP 1 PROPERTY OWNER (S)
STEP 2 PROPERTY LOCATION
PLEASE TYPE OR PRINT
TOWN/CITY COUNTY
MAP # LOT # BOOK # PAGE #
STREET
TOTAL ACRES IN PARCEL ACRES TO BE CLASSIFIED
STEP 3 CONSERVATION RESTRICTION INFORMATION
Restriction Granted to:
Restriction Recorded Book # Page #
Did you submit a map?
Does your map show the location and orientation of the property?
Does your map show the overall boundaries and acreages of land indicating that land
for which the conservation restriction assessment is and is not requested?
Yes No
Page 1 of 3
STEP 4 DOCUMENTATION
LAST NAME FIRST NAME
FORM
PA-60
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CONSERVATION RESTRICTION ASSESSMENT APPLICATION
(continued)
PA-60
Rev. 3/13
STEP 5 CONSERVATION LAND CATEGORIES
STEP 7 SIGNATURES OF A MAJORITY OF SELECTMEN/ASSESSORS
STEP 6 SIGNATURES OF ALL PROPERTY OWNERS OF RECORD
APPROVED DENIED
I/We certify that the land indicated above qualifies for assessment under the NH statutes and the Code
of Administrative Rules, and that all requirements will continue to be performed. I/We understand that,
should the use of the above-described land be disqualified, the land owner is liable for applicable penalty
for inconsistent use in accordance with RSA 79-B:6.
Page 2 of 3
To be eligible for the 20% recreation adjustment, and must be open to the public for skiing, snowshoeing,
fishing, hunting, hiking and nature observation. See RSA 79-B:3 for further information.
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
TYPE OR PRINT NAME (in black ink) SIGNATURE (in black ink) DATE
CATEGORY # ACRES 20% RECREATIONAL ADJUSTMENT
YES NO
FARM LAND
FOREST LAND:
HARDWOOD
ALL OTHER
FOREST LAND with DOCUMENTED STEWARDSHIP:
HARDWOOD
ALL OTHER
WETLAND
WHITE PINE
WHITE PINE
UNPRODUCTIVE LAND
FORM
PA-60
Instructions
PA-60
Instructions
Rev. 3/13
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CONSERVATION RESTRICTION ASSESSMENT APPLICATION
(continued)
WHO
MUST
FILE
WHAT
TO
FILE
APPEALS
WHERE
TO
FILE
ADA
NEED
HELP
Form PA-60, Conservation Restriction Assessment Application, shall be used by land owners applying for a conservation restriction
assessment, in accordance with RSA 79-B.
Land owners submitting a completed application, Form PA-60, shall also:
(1) Submit a map of the entire parcel, showing:
(a) The location and orientation of the property; and
(b) The overall boundaries and acreages of land indicating that land for which an easement is and is not requested; and
(2) A copy of the present recorded deed granting title to the applicant and a copy of the deed granting the conservation
restriction. A map is required of the entire parcel, adequately identified and oriented to establish its location. Besides
showing overall boundaries and computation of acreages, the map shall show interior boundaries and acreages of all
sub-categories of land for which the applicant is seeking qualification. Portions of the parcel not bearing the conservation
restriction or where there are reserved rights shall be clearly identified and appropriate acreages shown.
WHEN
TO
FILE
A completed Form PA-60, must be filed on or before April 15 of the tax year the conservation restriction assessment is to be granted.
Once completed and signed in black ink, this form and attachments shall be filed as follows:
Original: Register of Deeds
Copy: Local Assessing Officials
Copy: Land Owner
Pursuant to RSA 79-B:5, if any application for Conservation Restriction Assessment is denied, an applicant may appeal within six
months of any such action by the assessing officials in writing to the New Hampshire Board of Tax and Land Appeals or the County
Superior Court.
Forms for appealing to the Board of Tax and Land Appeals may be obtained from the NH Board of Tax and Land Appeals, 107
Pleasant Street, Concord, NH 03301 or by calling (603) 271-2578 or by visiting their web site at www.state.nh.us/btla. Be sure to
specify you are appealing the Conservation Restriction Assessment Application denial.
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 NH Department of Revenue Administration.
Contact your local municipality or the Property Appraisal Division at (603) 230-5950.
LINE-BY-LINE INSTRUCTIONS
STEP 1
STEP 3
STEP 4
STEP 5
STEP 6
STEP 2
Enter the conservation restriction information necessary to identify the present recorded deed granting title to the applicant.
Enter the name(s), address, municipality, state and zip code of the land owner(s) requesting a conservation restriction assessment
under RSA 79-B.
Enter the property location information of the land the restriction assessment applies to in the spaces provided. Enter the number of
acres in the parcel and the number of acres that are the subject of this application.
Enter the land categories that are requested for conservation restriction assessment.
Signatures of all the property owners, in black ink, are required on the lines provided. If more than four owners, submit a supplemental
list of all owners names of record and their signatures.
For selectmen/assessor use only. Signatures of a majority of the local selectmen or tax assessors on the lines provided indicates final
approval or denial as indicated by the box checked.
GENERAL INSTRUCTIONS
Page 3 of 3
Check the boxes to indicate whether your map includes the proper detail for the conservation restriction parcels to be identified.
Indicate whether you included the attachments listed are included.
STEP 7