FORM
PA-61
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
INCONSISTENT USE PENALTY ON CONSERVATION RESTRICTION LAND
PA-61
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
CONSERVATION RESTRICTION RECORDED IN: CHECK ONE:
STREET
OWNER NAME OF RECORD WHEN LAND WAS FIRST GRANTED CONSERVATION RESTRICTION ASSESSMENT
ACRES IN PARCEL MAP # LOT # BOOK # PAGE #
STEP 4 ASSESSMENT OF INCONSISTENT USE PENALTY
(a) Narrative description of the disqualification (ex. forest land converted to house lots):
(b) Actual date of change in use (MM/DD/YYYY)
(d) Inconsistent Use Penalty $
Page 1 of 3
PARTIAL RELEASE FULL RELEASE
BOOK # PAGE #
(b) Number of Acres Original Assessment
STEP 3 ACRES UNDER CONSERVATION RESTRICTION ASSESSMENT
(c) Number of Acres Previously Disqualified
(d) Acres Disqualified per this Assessment
(e) Number of Acres Remaining in Conservation Restriction
[3(b) minus 3(c) and 3(d)]
(c) Full and True Value at time of inconsistent use $
LAST NAME FIRST NAME
FORM
PA-61
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
INCONSISTENT USE PENALTY ON CONSERVATION RESTRICTION LAND
(continued)
PA-61
Rev. 3/13
STEP 5 INCONSISTENT USE PENALTY BILL
LAST NAME FIRST NAME
STREET ADDRESS
TOWN/CITY STATE ZIP CODE
PLEASE TYPE OR PRINT
STEP 6 CHECKS PAYABLE TO AND MAILED TO (COMPLETED BY TAX COLLECTOR)
STEP 7 SIGNATURES OF MAJORITY OF SELECTMEN/ASSESSORS
Page 2 of 3
SIGNATURE (IN BLACK INK) OF TAX COLLECTOR DATE PAID
(a) Actual Date of Inconsistent Use (MM/DD/YYYY)
(d) Total Inconsistent Use Penalty Due $
(c) Full and True Value at Time of Release $
(b) Date of Penalty Bill (MM/DD/YYYY)
(f) Payment of this tax is due no later than 30 days after mailing of this bill. Interest, at the rate of 18%
per annum, shall be due if this tax is not paid on or before
(a) Make Check Payable to:
NAME
ADDRESS
TOWN/CITY STATE ZIP CODE
(c) Tax Collector's Office Location:
(e) Include a separate check in the amount of $
(b) Mail To:
(d) Tax Collector's Office Hours:
Payable to County Register of Deeds for recording fee.
STEP 8 ACKNOWLEDGMENT OF PAYMENT
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
PA-61
Instructions
Rev. 3/13
FORM
PA-61
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
INCONSISTENT USE PENALTY ON CONSERVATION RESTRICTION LAND
INSTRUCTIONS
GENERAL INSTRUCTIONS
WHO
MUST
FILE
WHAT
TO
FILE
APPEALS
WHERE
TO
FILE
ADA
NEED
HELP
STEP 1
STEP 3
STEP 4
STEP 5
STEP 6
STEP 2
Form PA-61 shall be used by the local assessing officials to assess an Inconsistent Use Penalty on owners of land currently under
conservation restriction assessment who violate its restricted classification pursuant to RSA 79-B:6.
Local officials shall submit a completed Form PA-61 to the tax collector who shall cause a copy to be served upon the land owner along
with these “instructions” advising them of their appeal rights.
WHEN
TO
FILE
An inconsistent use penalty shall be assessed at the amount of 10% of the full and true value of the portion of land on which
inconsistent use has occurred, such as land that has been open space classified as restricted land, but has been developed or put to
a use either exercising any reserved rights to develop or violating its restricted classification.
Once completed and signed in black ink, this form and attachments shall be filed as follows:
Original: Register of Deeds after the Tax Collector collects the tax
Copy: Local Assessing Officials
Copy: Land Owner
Copy: Tax Collector
Within 2 months of the notice of the tax date and not afterwards, a land owner may apply in writing to the Selectmen or Assessors for
an abatement of the Inconsistent Use Penalty. If the Selectmen or Assessors neglect or refuse to abate the Inconsistent Use Penalty,
any person aggrieved may either apply in writing to the Board of Tax and Land Appeals or petition the County Superior Court within 8
months of the notice of the tax in accordance with RSA 79-A:10 or RSA 79-A:11.
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 that you are appealing the inconsistent use penalty on conservation restriction land denial.
Enter the original acreage under conservation restriction assessment acres, disqualified, and acres remaining.
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.
Enter the complete name(s), address, municipality, state and zip code of the land owner(s) who are being served an assessment due
to an inconsistent use of conservation restriction land.
Enter the location information of the land, the name of the original conservation restriction property owner of record, and whether this
is a full or partial release.
The tax bill to be completed by the local officials identifying the penalty to be assessed and to be collected by the tax collector.
The local assessing official shall complete the assessment of inconsistent use penalty.
LINE-BY-LINE INSTRUCTIONS
To be completed by the tax collector indicating to whom the land owner is to make the check payable and where to send it.
Acknowledgment of when the tax was paid and signed by the tax collector. Once the tax is paid, the original PA-61 must be filed with
the Registry of Deeds by the tax collector.
STEP 7
Signatures, in black ink, of a majority of the selectmen/assessors are required in the spaces provided to indicate approval of the
assessment.
STEP 8
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