Request for Voluntary Disqualication from
Present-Use Value Classication
Web
1-14
AV-6
Instructions
Use this form to: 1. Request voluntary disqualication from present-use value classication, and
2. Cause the deferred taxes for the current year and the three preceding years to be due and payable as a result of the voluntary
disqualication.
The deferred taxes for the three tax years preceding disqualication become due and payable when the property is disqualied from
present-use value classication. (G.S. 105-277.4(c))
Voluntary disqualication should not be requested if you wish to pay any or all of the deferred taxes and still retain your present-
use value classication. File Form AV-3, not this form, if you wish to voluntarily pay some or all of your taxes and retain present-
use value classication.
Important! Please Read! -- Once this form has been signed and led with the tax assessor, the request cannot be rescinded
or reversed. The ling of the form results in disqualication. The deferred taxes become due and payable as of the date of
disqualication.
The date of disqualication is the date that this form is led with the tax assessor.
There is no statutory provision for releasing or refunding a tax imposed due to voluntary disqualication, even if voluntary
disqualication was requested in error by the owner.
PLEASE CONSIDER YOUR REQUEST CAREFULLY.
Parcel ID
Total Acres
in Parcel
Full or Partial
Disqualication
(check one)
List the parcel(s) for which voluntary disqualication from present-use value classication is requested.
If partial disqualication, describe and state
the number of acres to be disqualied.
Attach plat and/or documentation.
Full Partial
Full
Full
Full
Full Partial
Partial
Partial
Partial
Full Name of Owner(s)
Telephone Number Fax Number
Comments:
4
PRINT
CLEAR
Page 2, AV-6, Web, 1-14
Voluntary Payment of Deferred Taxes Without Disqualication - File Form AV-3, not this form, if you wish to pay any or all of the
deferred taxes without being disqualied from the present-use value program. G.S. 105-277.1F allows a property owner receiving
present-use value to pay any or all of the deferred taxes for that property without affecting the eligibility of the property for present-use
value classication. The payments are immediately applied to the existing deferred taxes and are not held for application to additional
deferred taxes resulting from any future removal from the program.
Request for Estimate of Deferred Taxes - File Form AV-7, not this form, if you are only requesting an estimate of deferred taxes
potentially due as of the estimate date. An estimate does not disqualify the property from present-use value classication.
ACKNOWLEDGEMENT
I (we), the undersigned, hereby acknowledge the following:
1. I (we) are the owner(s) of record of the above listed property on the date this form is led with the tax assessor.
2. I (we) acknowledge that voluntary disqualication should not be requested if I (we) wish to voluntarily pay the deferred
taxes and still retain present-use value classication.
3. Voluntarily disqualication from present-use value classication is requested for the above listed property.
4. The date of voluntary disqualication is the date that this form is led with the tax assessor.
5. I (we) understand that the request for voluntary disqualication, once led with the tax assessor, cannot be rescinded
or reversed. If the request was made in anticipation of a property transfer but the property does not actually transfer,
the owner may be able to immediately re-qualify for the next tax year under certain conditions; however, the taxes billed
as a result of the disqualication resulting from the ling of this form remain in force.
6. Voluntary disqualication (but not voluntary payment only) will preclude a potential buyer from immediate present-use
value eligibility under the provisions of G.S. 105-277.3(b2)(1) for Continued Use. The new owner may or may not be able
to immediately qualify under other statutory provisions for the next tax year.
Contact Person for Owner’s Attorney Phone Fax
Name (Owner or Owner’s Attorney - Please Print) Signature (Owner or Owner’s Attorney) Date
Name (Owner or Owner’s Attorney - Please Print) Signature (Owner or Owner’s Attorney) Date
Name (Owner or Owner’s Attorney - Please Print) Signature (Owner or Owner’s Attorney) Date
Name (Owner or Owner’s Attorney - Please Print) Signature (Owner or Owner’s Attorney) Date
ASSESSOR’S USE ONLY: DATE FILED:____________________________________ MAIL HAND-DELIVERED
Signatures—All owners must sign this form. An attorney licensed to practice law in North Carolina who is representing the
current owner may sign for the owner. All tenants of a tenancy in common must sign this form. If husband and wife own the property as
tenants by the entirety, either the husband or the wife may sign, but both are recommended to sign. All general partners of a partnership
must sign. An ofcer of a corporation may sign for the corporation. An ofcer of an LLC may sign for the LLC. A trustee may sign for the
trust.