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PT-283R - Rev. 8/07 APPLICATION FOR CURRENT USE ASSESSMENT OF RESIDENTIAL TRANSITIONAL PROPERTY To the Board of Tax Assessors of In accordance with the provisions of O.C.G.A. § 48-5-7.4, I submit this application for consideration of current use assessment on the property described herein. Along with this application, I am submitting the fee of the Clerk of Superior Court for recording such application if approved. Name of owner (individual(s)) Owner’s mailing address City, State, Zip If within city limits, provide city name Property location (Street, Route, Hwy, etc.) City, State, Zip Total number of acres – but no more than 5 District Land Lot Sublot & Block Recorded Deed Book/Page Enter name under which a homestead exemption has been approved on this property AUTHORIZED SIGNATURE I, the undersigned, do hereby solemnly swear, covenant and agree that all the information contained above is true and correct to the best of my knowledge and that the above described property qualifies under the ownership and land use provisions of O.C.G.A. § 48-5-7.4. I further swear that I am authorized to sign this application on behalf of the owner(s) making application that no individual associated with the ownership of this property has any beneficial interest in more than 2,000 acres in this or any other conservation use property in Georgia, and that certain penalty provisions are applicable if this covenant is breached. Sworn to and subscribed before me this day of Signature of Taxpayer or Taxpayer’s Authorized Representative Date Filed Notary Public If denied, Georgia law O.C.G.A. § 48-5-7.4 provides that the applicant may appeal in the same manner as other property appeals are made pursuant to O.C.G.A. § 48-5-311. FOR TAX ASSESSORS USE ONLY Map and Parcel Number Tax District Taxpayer Account Number Yr Covenant: Begins: Jan 1 Ends: Dec 31 Date property split from a conservation use covenant of bona fide agricultural property: If applicable, covenant is a renewal for tax year: Beginning Jan 1, Ending: Dec 31, If applicable, covenant is a continuation for tax year Beginning Jan 1, Ending: Dec 31, Based on the information submitted above, the County Board of Tax Assessors has considered such information and has made the following final determination of this application: Approved: Date: Board of Tax Assessors Date Denied: Date: If denied, the County Board of Tax Assessors shall issue a notice to the taxpayer in the same manner as all other notices are issued pursuant to O.C.G.A. § 48-5-306. APPLICATION FOR RELEASE OF CONSERVATION USE ASSESSMENT OF RESIDENTIAL TRANSITIONAL PROPERTY I, the owner of the above described property, having satisfied all applicable taxes and penalties associated with the covenant above, do hereby file this application for release of conservation use assessment with the county board of tax assessors. Pursuant to O.C.G.A. § 48-5-7.4(w), no fee is required for the clerk of superior court to file and index this release in the real property records of the clerk’s office. Sworn to and subscribed before me This day of Taxpayer’s Authorized Signature Approved by: Board of Tax Assessors Notary Public Date Filed Date Approved PRINT CLEAR AUTHORIZED SIGNATURE FOR TAX ASSESSOR USE ONLY APPLICATION FOR RELEASE OF CONSERVATION USE ASSESSMENT OF RESIDENTIAL TRANSITIONAL PROPERTY