State Tax Form Cl 1 – Fill Out and Use This PDF

Fiscal Year _______ Application for

Forest-- Agricultural or Horticultural -- Recreational Land Classification

General Laws Chapter 61, §§ 1 & 2 – Chapter 61A, § 6 – Chapter 61B, § 3

INSTRUCTIONS: Complete all sections that apply. Please print or type.

A.IDENTIFICATION. Complete this section fully.

Name of Applicant(s):

Mailing Address:

No. Street

City/Town

Zip Code

Property Covered by Application:

B. TYPE OF CLASSIFICATION. Check the classification you are seeking and provide the required information.

FOREST Attach State Forester’s Certificate and Approved Forest Management Plan.

AGRICULTURAL or HORTICULTURAL

1.Current use of land. List by classes established by the Farmland Valuation Advisory Commission, if applicable.

a.Vegetables, Tobacco, Sod and Nursery Cropland

b.Dairy, Beef and Hay Cropland

c.Orchards, Vineyards and Blueberries Cropland

d.Cranberries

e.Christmas Trees

f.Productive Woodland (Attach copy of State Forester’s Certificate and Approved Management Plan if initial application, or new/revised plan)

g.Cropland Pasture, Permanent Pasture and Necessary and Related Land

h.Contiguous Non-productive Land

i.Other Agricultural or Horticultural (Specify)

2.Statement of income in preceding year. Supporting documentation, including copies of your federal and state tax income returns, may be requested to verify your income.

a. Gross sales from agricultural or horticultural use	$
b. Amount received under MA or US Soil Conservation or Pollution Abatement Program	$
Total (Provide a detailed description of the source of the farm income listed above)	$

3.Previous use of land. Was the land valued, assessed and taxed as classified agricultural or horticultural land

	under c. 61A for the prior 2 fiscal years?	Yes		No
If no, was the use of the land during the prior 2 fiscal years the same as the current use described above?					Yes	No
If no, describe in detail the use of the land during the prior 2 fiscal years
If no, was your farm income during either of the prior 2 fiscal years less than the amount reported above?
Yes	No

If yes, list the income for the year $ __________________________ Fiscal year _____________

THIS FORM APPROVED BY THE COMMISSIONER OF REVENUE

RECREATIONAL	Land may qualify based on its condition or recreational use.
1. Is the land retained in substantially a natural, wild or open condition? Yes		No
Is the land in a landscaped or pasture condition or managed forest condition?		Yes	No

If managed forest, attach copy of State Forester’s Certificate and Approved Management Plan if initial application, or new/revised plan.

Does the land allow to a significant extent the preservation of wildlife and other natural resources? Yes	No
If yes, indicate which natural resources are preserved:

Hiking

Target Shooting

Hunting

Private Non-commercial Flying

Boating

Skiing

Swimming

Horseback Riding

Commercial Horseback Riding &

Equine Boarding

How often is the land used for recreational activities?

How many people use the land for those activities?

Is the land open to the general public? Yes	No
If no, to whom is its use restricted?

Is the land used for horse racing, dog racing or any sport normally undertaken in a stadium, gymnasium or

similar structure? Yes

No

C. LESSEE CERTIFICATION. If any portion of property is leased, the following statement must be signed by each lessee.

I hereby certify that the property I lease is being used as described in this application and that I intend to use the

property in that manner during the period to which the application applies.
Lessee	Date

D.SIGNATURE. All owners must sign here to complete the application.

This application has been prepared or examined by me. Under the pains and penalties of perjury, I declare that to the best of my knowledge and belief, it and all accompanying documents and statements are true, correct and complete. I also certify that I have signed and attached a Property Owner’s Acknowledgement of Rights and Obligations under classified forest, agricultural or horticultural or recreational land programs, as part of this application.

Owner		Date

If signed by agent, attach copy of written authorization to sign on behalf of taxpayer.

DISPOSITION OF APPLICATION (ASSESSORS’ USE ONLY)